Increase in calcium channel current by beta-adrenoceptor agonists in single smooth muscle cells isolated from porcine coronary artery.

1. The action of catecholamines (isoprenaline and noradrenaline) and forskolin on membrane currents was studied in single cells freshly dispersed from the pig coronary artery by use of the whole-cell clamp method, usually with electrodes containing CsCl. 2. In normal Krebs solution, with and without 30 mM tetraethylammonium (TEA) and 0.5 mM 4-aminopyridine, isoprenaline (1-5 microM) clearly increased the inward currents elicited by membrane depolarization, without affecting the holding current at -80 mV. The same effect was observed when the external Cl- was replaced with isethionate. The outward current recorded with K(+)-containing electrodes was not significantly affected by isoprenaline. 3. In the presence of 67 mM Ba2+ and 30 mM TEA, the maximum inward current recorded with CsCl containing electrodes was 119 +/- 7 pA (the mean +/- s.e.mean, n = 90) in cells where the current was larger than 30 pA. The L-type Ca2+ channel was considered to be responsible for these currents, based on the threshold voltage, the slow time course of decay, the large depolarization necessary to produce inactivation, and the high susceptibility to the Ca2+ channel antagonist, nicardipine. 4. Isoprenaline and noradrenaline increased the amplitude of inward currents evoked by depolarizing pulses. The maximum inward current was potentiated by 43 +/- 7% (n = 12) by isoprenaline and 39 +/- 10% by noradrenaline (n = 6) at a concentration of 1 microM. These effects were strongly inhibited by propranolol, but not phentolamine. Forskolin (10 microM) also potentiated the currents to a similar degree. 5. It is suggested that stimulation of beta 3-adrenoceptors increases the amplitude of inward currents through L-type Ca2 + channels in the pig coronary artery and that intracellular cyclic adenosine monophosphate is likely to be inolved in this action.

Activation of prophenoloxidase with 2-propanol and other organic compounds in Drosophila melanogaster.

Activation with 2-propanol and other organic compounds of prophenoloxidase purified from pupae of Drosophila melanogaster was analyzed. A1, one of the two isozymes of the prophenoloxidase, could be activated with both an endogenous activating system and artificial organic compounds including alcohols. A1 was activated within 2 min after addition of 2-propanol. The phenoloxidase activity of A1, which had been activated with 2-propanol, decreased gradually by lowering the concentration of 2-propanol taking c 60 min to attain a low level, and the activity could be re-elevated at the re-introduction of 2-propanol. Thus the reversibility of the activation of A1 in response to the change of the concentration of 2-propanol in the activating mixture could be observed. Optimum concentration of 2-propanol for the rate of activation was 50%, optimum temperature was 30 degrees C and optimum pH was 7.5. The final level of the phenoloxidase activity, which had been activated with 2-propanol, was higher than that activated with the endogenous activating system. The activated state of A1 showed properties of a tyrosinase-type phenoloxidase. The results suggested that the activation of A1 with 2-propanol is caused by the reversible conformational change of the prophenoloxidase molecule.

Activation of prophenoloxidase A1 by an activating enzyme in Drosophila melanogaster.

An activating enzyme for prophenoloxidase A1 was isolated from pupae of Drosophila melanogaster, and the activation of purified prophenoloxidase A1 with this enzyme was analyzed. The purification included ammonium sulfate fractionation, DEAE-cellulose, Superdex 75, arginine-Sepharose and hydroxyapatite column chromatography. The prophenoloxidase activating enzyme was determined to be a 28.5-kDa protein consisting of a single polypeptide. The kinetics of the activation reactions was unusual in that the final levels of phenoloxidase activity varied depending on the initial concentrations of the activating enzyme, not those of the prophenoloxidase. The activation was effectively suppressed by the inhibitors of trypsin-type serine protease. The protein has amidolytic activity, and Boc-Val-Pro-Arg-MCA was the best substrate among the synthetic substrates examined. The molecular mass of the activated phenoloxidase was smaller than that of the prophenoloxidase, indicating that a 5-kDa peptide was released from the prophenoloxidase by limited proteolysis with the activating enzyme. The cleavage site of prophenoloxidase A1 was shown to be between Arg and Phe at positions 52 and 53.

Prepontine epithelium-lined cyst. Case report.

A 30-year-old woman presented with recurrent episodes of severe headache associated with visual disturbances. Neurological examination showed minimal neurological defects. Angiography, computerized tomography, and radioisotope cisternography revealed a large cyst in the prepontine region, which did not communicate with either the subarachnoid space or the ventricular system. Histologically, the cyst was lined by columnar and/or cuboidal cells, which contained materials positive on periodic acid-Schiff staining. Ultrastructurally, there were two types of cells, ciliated and noncillated. Characteristic findings were continuous basement membrane, microvilli covered with electron-dense material, several intercellular junctional devices, and an open intercellular space which was occasionally filled with a migrating cell. These findings would support the view that the epithelial cyst with such features was derived from endodermal tissues rather than from neuroepithelium. Electron microscopic examination is indispensable in making a correct diagnosis of intracranial cysts.

Mycotic aneurysms of the internal carotid artery. Case report.

The authors report a case with two mycotic aneurysms in the cavernous portion of the internal carotid artery, presumably secondary to a transient bacteremia from pneumonia. The strikingly rapid development of the aneurysms was demonstrated by angiography. Painful total ophthalmoplegia and extophthalmos were the main clinical features.

[Cerebral and pulmonary arteriovenous fistula with possible hereditary hemorrhagic telangiectasia: case report].

Hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber disease) is a syndrome characterized by the presence of mucocutaneous telangiectasia, recurrent hemorrhage (epistaxis from nasal telangiectasia is by far the most common form), and hereditary occurrence. Hereditary hemorrhagic telangiectasia is thought not to be a simple mucocutaneous disease but a generalized vascular dysplasia, because multiple visceral organs and systems, including central nervous system, are involved. But, an involvement of the central nervous system in this disease is rare. We experienced a case with cerebral arteriovenous fistula that was also diagnosed as possible hereditary hemorrhagic telangiectasia. In this communication this case is reported and the relevant literature is reviewed. A 30-year-old male, who was diagnosed as having possible hereditary hemorrhagic telangiectasia, was found to have abnormal findings on head CT scan during the evaluation of his disease. So he was admitted to the neurosurgical department for further examination. He was also known to have pulmonary arteriovenous fistula (11.5% arteriovenous shunt) and secondary polycythemia (RBC 533 X 10(4)/mm3, Hb 17.6 g/dl, Ht 51%). His past medical history was noteworthy for several episodes of epistaxis since childhood. His uncle had also pulmonary arteriovenous fistula and was operated on at another hospital. On admission, he was alert and showed normal neurological findings. Routine x-ray of the skull showed abnormal thinning of the skull in the right parietal region. Computed tomograms showed a lobulated high-density mass in the right parietal lobe which was homogeneously enhanced after bolus injection of contrast material. Right carotid angiograms disclosed a dilated aneurysmal vein in the parietal lobe.(ABSTRACT TRUNCATED AT 250 WORDS)

[Facial nerve schwannomas: report of two cases].

Although schwannoma may arise from any true cranial nerve, it is well known that the acoustic and trigeminal nerves are frequent origins. Schwannomas of the facial nerve are rare. In this communication, two cases of facial nerve schwannoma arose from the horizontal portion are reported. Case 1. A 44 year-old male was admitted to our clinic complaining of left hearing loss and facial asymmetry. About three years prior to the admission, he first noticed left hearing disturbance which was gradually deteriorated and was transiently accompanied by left tinnitus during the progression. Then muscle spasm developed on the left eyelid which resolved spontaneously in a few weeks, then asymmetry of the face developed. Neurological examination on admission revealed left hearing loss and left peripheral facial palsy. As a result of neuro-otological examinations, left hearing impairment and left facial palsy were thought to be due to retrocochlear and suprageniculate lesions respectively. Plain skull radiograms and tomograms revealed marked destruction of left pyramis and enlarged internal auditory canal. Computed tomography of the brain showed low-density mass in the left middle fossa and defect of the tip of the left pyramis. After bolus injection of contrast material, peripheral portion of the middle fossa mass was enhanced non-homogeneously and enhanced mass extended to the posterior fossa. Left middle and posterior fossas were explored by carrying out a osteoplastic temporal flap and suboccipital craniectomy. A large extradural mass was noted to have filled the middle fossa which extended to the posterior fossa through destroyed pyramis and enlarged internal auditory canal. The tumor was removed subtotally.(ABSTRACT TRUNCATED AT 250 WORDS)

[Giant cell tumor of the temporal bone--case report (author's transl)].

The majority of giant cell tumors occurs in the long bones, especially around the knee, and only 1.4-1.8% of cases are found in the skull. In this communication, a case of giant cell tumor of the temporal bone is reported because of a rarity of the lesion in the skull. The 37-year-old housewife was admitted to our clinic complaining of swelling in right temporal region which had gradually developed over a two-month period. On examination, there was a swelling about 5cm in diameter beneath right temporal muscle; its surface was smooth and its consistency was hard. Tenderness was found in its center. Routine x-ray of the skull showed osteolytic lesion in right temporal bone with relatively clear margins. Computed tomography demonstrated heterogeneously high-density mass in right temporal bone and right middle fossa. The tumor located mainly within the temporal bone at the middle fossa, and intracranial epidural space at the convexity. After bolus injection of contrast material, the tumor of temporal bone and the peripheral portion of the intracranial tumor were enhanced markedly. Right external carotid angiograms disclosed tumor stain in capillary and venous phases. Abnormal RI uptake was disclosed by bone scintigrams with 99mTC-methylene diphosphonic acid. Her preoperative diagnosis was calvarial tumor with intracranial extension. A right fronto-temporal osteoplastic craniotomy was performed. The tumor located within the temporal bone and in epidural space which invaded temporal muscle and underlying dura. The tumor was elastic soft and vascular with central necrosis. The tumor was extirpated totally including surrounding temporal muscle and dura. Microscopic examination of the operative specimen revealed giant cell tumor of the skull. Therefore, she was treated with 60CO irradiation (3,000 rads) to the temporal region. In the 13 months since the completion of treatment, there has been no sign of recurrence nor metastasis. Giant cell tumor of the skull were reviewed with special references to diagnosis and treatment. Computed tomographic findings of this tumor were also discussed briefly.

[RI cisternography in the diagnosis of brain tumors (author's transl)].

Fifteen cases of brain tumors of supratentorial location were studied by RI cisternography; Cisternographical patterns of decreased or absent radioactivity were classified into five groups as follows: Pattern I: Sharply circumscribed and localized decrease in radioactivity; Pattern II:Ill-defined and focal decrease in radioactivity; Pattern III: Areal decrease in radioactivity involving one whole or two lobes; Pattern IV: Hemispherical decrease in radioactivity and Pattern V: Total decrease in radioactivity in the head. Each pattern appears to correspond well with topographical features of brain tumors and their related pathology, such as extracerebral tumors (pattern I), intracerebral but superficially located tumors (pattern II), extracerebral tumors with surrounding edema or large intracerebral tumors (pattern III), extracerebral or intracerebral tumors with increased intracranial pressure (pattern IV), and extremely increased intracranial pressure regardless the site of tumor (pattern V). In consideration of these patterns, RI cisternography would be a more useful supplementary method in diagnosis of brain tumors to detect the area involved, to differentiate an intracerebral from an extracerebral tumor, and to find a recurrence of the tumormfurthermore, it is helpful to know the therapeutical effects of surgery and radiotherapy. RI cisternography is a simple, relatively noninvasive method which can be used more widely.

[Preoperative embolization with gelfoam powder for intracranial meningioma causing unusual peritumoral hemorrhage--with reference to the mechanism of hemorrhage].

Preoperative embolization for intracranial meningioma has been performed at many institutions and its effectiveness has been well recognized. The complications of embolization such as facial pain, fever and facial nerve palsy, et al, were mild and temporary except embolus migration into intracranial vessels, but a peritumoral hemorrhage due to preoperative embolization was extremely rare. Recently we have experienced such an unusual complication, then we describe this complication here and discuss the mechanism of hemorrhage briefly. A 73-year-old female who had the left falx meningioma underwent preoperative embolization with gelfoam powder through the transfemoral route. About 10 hours later, she developed disturbance of consciousness and right hemiplegia. At that time, CT scan showed peritumoral hemorrhage and an increase in midline shift. An emergency craniotomy was performed and total removal of the falx meningioma (Simpson grade II) and evacuation of the hematoma were done. The postoperative course was uneventful. We conclude that gelfoam powder (average particle size 40-60 mu) is a useful material for preoperative embolization but may at times cause peritumoral hemorrhage.

[Unusual case of depressed fracture of the posterior cranial fossa associated with the syndrome of acute central cervical spinal cord injury].

Linear fractures through the occipital bone are common, whereas depressed fractures in the posterior cranial fossa are rare because the occipital bone is protected by the surrounding thick muscles. The authors describe an unusual case of depressed fracture localized in the posterior cranial fossa associated with the syndrome of acute central cervical spinal cord injury. A 50-year-old female struck her face against the table and fell backward, while drunk, resulting in the bruise over the occipital region. Three days after injury she was transferred to our hospital because of progressive disturbance of consciousness, brain stem dysfunction and tetraplegia. Neurological examination on admission showed that she was drowsy, had tetraplegia and could not speak. However, she could obey commands only by moving her eyes and the ocular movements were normal in all directions except for horizontal nystagmus. Plain skull x-ray revealed a conspicuously depressed fracture in the posterior cranial fossa, but cervical spine x-ray showed neither fracture nor dislocation. Immediately suboccipital craniectomy was done and there were a thin subdural hematoma on the cerebellar surface, cerebellar contusion, and subarachnoid hemorrhage around the cisterna magna. Soon after operation impaired consciousness and paraplegia were improved, but recovery of both arms was delayed. Five months after injury, she still had left IX, X and XI nerve paresis, bilateral arm weakness, dysarthria, swallowing disturbance and bilateral sensory disturbance below C4 level. These findings indicated that she had sustained brain stem and cerebellar compression by the depressed fracture and also had suffered an acute central cervical spinal cord injury.

[Facial palsy following head injury: topognosis, prognosis and indications for surgical decompression].

It is a common experience that the facial nerve is affected in closed head injury. 781 patients with head injury were treated at Kobe Central Municipal Hospital over a period of 5 years from January 1977 to April 1982, and facial palsy occurred in 25 cases (3.2%). The male to female ratio was 22: 3 and age ranged from 9 to 78 (average 36). The patients were studied, using radiological, topognostic and electrodiagnostic methods. Facial nerve decompression was done in 5 cases and 20 cases were treated conservatively. Results were as follows. The overall rate of complete recovery was 64% (16 of 25 cases). In the conservative treatment group, all patients with incomplete paralysis and normal maximal stimulation test (MST) recovered completely. With complete paralysis, if the initial nerve excitability (MST) was normal, recovery could be expected by conservative treatment. Even if the patients had abnormal nerve excitability (MST) at first, complete recovery could be observed, when signs of recovery could be elicited and normalization of MST occurred within 3 weeks from the onset of the palsy. In severe cases, even with abnormal MST from the onset, complete or partial recovery can be expected after surgery. Therefore, microsurgical decompression of the facial nerve is indicated in the following cases: patients with complete paralysis and no response to MST from the onset. patients with complete paralysis and deteriorating response to MST 1 month after onset. Maximal stimulation test is a good guide for determining the necessity for surgical intervention.

[RI cisternography with 111-In-DTPA].

In contrast to 169Yb-DTPA the usage of 111In-DTPA, a new radiopharmaceutical, is not as yet popular for RI cisternography. This report deals with a comparative study of these two radiopharmaceuticals for RI cisternography. For the past one year 301 RI cisternography. For the past one year 301 RI cisternographies were performed in 160 cases at the Neurosurgical Survice of Shizuoka Rosai Hospital. Among those 169Yb-DTPA was used in 137 occasions, 111In-DTPA in 53, and both 169Yb-DTPA and 111In-DTPA in 30. The results of this study were as follow. 1. 111In-DTPA was chemically stable in intrathecal administration. 2. A reactive fever was minimal with 111In-DTPA if any. 3. There was no adverse reaction, such as aseptic meningitis, following 111In-DTPA cisternographies. 4. The effective half-life of 111In-DTPA was 16 hours, and that of 169Yb-DTPA 22 hours in this series. This means the men were exposed to radioactivity less with 111In-DTPA than with 169Yb-DTPA. 5. However, there was no difference in diagnostic value between these two radiopharmaceuticals, even 48 hours after intrathecal administration. From this study 111In-DTPA appears to be more suitable for RI cisternography than 169Yb-DTPA.