Effect of prothrombin complex concentrate on INR and blood coagulation system in emergency patients treated with warfarin overdose.

We investigated the effect of prothrombin complex concentrate (PCC) on the international normalized ratio (INR) and blood coagulation system in two emergent patients treated with warfarin for secondary prevention of cardioembolic stroke due to nonvalvular atrial fibrillation. An 80-year-old woman developed massive subcutaneous hemorrhage and swelling on her right upper extremity with weak pulsation of the right radial artery and had an INR above 10. An 83-year-old man had pleural effusion with an INR value of 6.69 and pleural puncture was immediately required. We administered 500 IU of PCC to the two patients (17.2 IU/kg and 12.5 IU/kg) with 10 mg of vitamin K. The INR decreased to 1.12 and 1.85, respectively, with an increase of plasma levels of protein C and coagulant factors IIa, VIIa, IXa, and Xa 10 min after administration. The plasma levels of the thrombin-antithrombin III complex increased (from 4.0 to 12.0 micro g/l and from 0.5 to 28.9 micro g/l, respectively, normal value <3.0), but prothrombin fragment 1+2 increased minimally 10 min after administration (from 0.4 to 1.1 nmol/ml and from 0.4 to 0.7 nmol/ml, respectively, normal value 0.4-1.4 nmol/ml). Plasma levels of D-dimer remained unchanged. The massive subcutaneous hemorrhage in the former patient improved in 14 days. Anticoagulation was restarted in the latter patient after 14 days of PCC administration. There were no embolic episodes during the month after PCC administration. In conclusion, a small amount of PCC may be effective in immediately correcting increased INR levels with increased plasma levels of protein C and coagulant factors IIa, VIIa, IXa, and Xa and may partially activate the coagulation system without any effects on plasma levels of D-dimer.

The Lurcher mutation reveals Ca(2+) permeability and PKC modification of the GluRdelta channels.

The physiological function of the GluRdelta subfamily which is one of the glutamate receptor (GluR) channel subunits has not yet been clarified, because no GluR channel activity has been detected in heterologous expression systems. The Lurcher mutation, a point mutation of the GluRdelta2 subunit, converts it into a constitutively active and cation-permeating channel. We introduced this mutation into GluRdelta1 and GluRdelta2, AMPA-selective, and NMDA-selective GluR channel subunits, and characterized their channel properties. It was shown that the Lurcher mutation alters the gating properties of AMPA- and NMDA-selective GluR channels, but not their cation permeabilities nor metabolic modulations. These findings support the idea that the Lurcher mutant homomeric GluRdelta1 channels are permeable to Ca(2+) as do the mutant GluRdelta2 channels, reflecting their original channel properties. We also found that cation permeability of the mutant GluRdelta1 channels was decreased by TPA, a protein kinase C activator. It indicates the possibility that phosphorylation by PKC activation may inhibit channel with wild-type GluRdelta1 subunit.

Differential palmitoylation of two mouse glutamate receptor interacting protein 1 forms with different N-terminal sequences.

Glutamate receptor interacting protein (GRIP) is a member of the PDZ domain-containing protein family that is localized in the postsynaptic density area. This protein has been reported to interact specifically with the C-termini of AMPA-selective glutamate receptor channel subunits, GluRalpha2 and GluRalpha3 through its PDZ domains. To clarify the physiological functions of GRIP, we cloned mouse GRIP1, and found that there are three sites for alternative splicing and two putative translational start codons by characterizing GRIP1 cDNA clones and reverse transcription-polymerase chain reaction products. Metabolic labeling of COS-7 cells expressing two N-terminal GRIP1 proteins demonstrated that these proteins differed in their pattern of palmitoylation. These findings suggested that the molecular diversity of GRIP1 underlies the localization and functional heterogeneity of this protein.

Stressful delivery influences circulating thrombopoietin (TPO) levels in newborns: possible role for cortisol in TPO-mpl binding.

The regulation mechanism of circulating thrombopoietin (TPO) level in human newborns remains unknown. In the present study, we examined whether the TPO concentrations in cord blood were influenced by the difference in the delivery method and the presence or absence of maternal/fetal complications. Cortisol levels were simultaneously measured to assess the adrenal response of fetuses. Both the TPO level and the cortisol level were substantially greater in the neonates delivered vaginally with and without the complications than in those delivered by cesarean section without the complications. The binding assay showed that the incubation of mpl(+)/BaF3 cells with cortisol gave rise to a significant decrease in the binding sites of TPO. These results suggest that the stress to the fetuses near the time of delivery affects the cord blood TPO levels, which may be mediated in part by the action of cortisol on the TPO-mpl binding system.

Non-invasive diagnosis of a Schwannoma by ultrasonography: a case study.

A 52-year-old female came to this institution complaining of a right leg mass lesion. Ultrasonography showed a 16 x 12 x 20mm hypoechoic solid mass lesion in the right leg. The patient underwent surgery during the diagnosis of Schwannoma. Preoperative diagnosis of Schwannoma is difficult by examination. Computerized tomography and magnetic resonance imaging, showed the origin of Schwannoma. However, the lesion was noted to be in a direct continuity with the cord-like echogenic structure consistent with a nerve by echography. We prefer to conduct preoperative examination by ultrasonography in patients with Schwannoma. In conclusion, we have reported a case of Schwannoma diagnosed by non-invasive ultrasonography.

[A case of brain infarction of lateral geniculate body showing strange formed scotomas].

A 58-year-old woman suddenly noticed that soccer players disappeared and emerged in right inferior portion of her vision while she was watching soccer game on TV. She was admitted in our hospital on the day 9. Goldman perimeter revealed strange formed hemianopic soctomas which located at right side of her both visual fields. Brain MRI scan showed a tiny infarction in left lateral geniculate body. No abnormalities were found on cerebral angiography and 24 hours holter ECG study. Transesophageal echocardiography and transcranial Doppler study showed the presence of intracardiac right-to-left shunting via atrial septum defect. Paradoxical embolism was considered and oral anticoagulation therapy was started. Her visual defect disappeared by the day 79. Strange formed homonymous hemianopic scotomas were attributable to highly localized small lesion in left anterior choroidal artery territory of lateral geniculate body.

Increased macrophage-colony stimulating factor levels in neonates with perinatal complications.

OBJECTIVE: To examine whether perinatal complications induce the production of macrophage-colony stimulating factor (M-CSF), we have compared M-CSF levels in the cord blood between normal neonates and neonates with complications. METHODS: The M-CSF levels were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: In 54 normal neonates, the M-CSF level was 1859 +/- 287 U/ml (mean +/- S.D.), being significantly higher than the serum M-CSF level in normal adults (697 +/- 132 U/ml). Compared with M-CSF levels in normal neonates, significantly higher levels were evidenced in neonates with perinatal complications including premature rupture of the membranes, neonatal asphyxia, meconium staining of the amniotic fluid and maternal anemia. However, no difference in M-CSF concentrations was observed irrespective of complication types; furthermore, the M-CSF level was highly correlated with the leukocyte counts in the neonates with complications, but not in normal neonates. Incidentally, CRP levels were within normal limits in most of these neonates, CONCLUSION: M-CSF levels in the cord blood from neonates with premature rupture of the membranes, neonatal asphyxia, meconium staining of the amniotic fluid and maternal anemia were significantly higher than those in the cord blood sampled from normal neonates. The stress given to neonates may account for the higher M-CSF levels rather than infections.

Detection of Palmaz-Schatz stent by ultrafast CT.

We present a case of Palmaz-Schatz stent in the anterior descending coronary artery in a patient in whom restenosis occurred repeatedly after balloon angioplasty. The location of the stent was confirmed by ultrafast CT. The Palmaz-Schatz stent is barely visible by fluoroscopy and confirmation of its location by fluoroscopy is difficult after failure of stent delivery. However, ultrafast CT enabled the clear detection of a Palmaz-Schatz stent without artifacts and may be valuable in confirming its location.

Increased granulocyte-colony stimulating factor (G-CSF) levels in neonates with perinatal complications.

We have investigated cord blood granulocyte-colony stimulating factor (G-CSF) levels in neonates with or without neonatal complications to examine some changes in the G-CSF levels in the neonatal period. The G-CSF levels were measured in 613 neonates by enzyme immunoassay. The results showed that G-CSF levels were distributed in a broad range from the level under the cutting point (31 pg/mL) to over the measurable range (2000 pg/mL). Normal neonates without perinatal complications were 322. In normal neonates, the G-CSF level correlated with the gestational age (r = 0.255, P < 0.01) and cord blood leukocyte count (r = 0.210, P < 0.01). The G-CSF values were under 100 pg/mL in 95% of normal neonates with a median of 35.0 pg/mL. We divided the neonates into two groups: a lower (< 100 pg/mL) and a higher (> or = 100 pg/mL), based on the G-CSF level. The percentage of neonates with higher G-CSF levels (> or = 100 pg/mL) was greater in neonates with perinatal complications than in normal neonates (< 100 pg/mL; P < 0.01). Compared with normal neonates, the percentages of the higher group were greater in neonates with infections (P < 0.01), fetal distress (P < 0.01), premature rupture of membranes (P < 0.05), neonatal asphyxia (P < 0.01) and meconium staining of amniotic fluid (P < 0.01). Neonates with higher G-CSF levels had larger numbers of peripheral leukocytes (P < 0.05) than did those with the lower G-CSF levels. Counts of leukocytes were parallel with those of neutrophils.(ABSTRACT TRUNCATED AT 250 WORDS)

The embryo pancreas is a source of increased yolk amylase in the fertilized eggs of domestic fowls.

The amylases were studied in the yolk of fertilized eggs and in the pancreases of the embryos of domestic fowls. The amylase activity in the yolk increased markedly from 13 days of incubation until hatching, but the activity decreased when the embryos were taken out of the eggs. The isoamylases in the yolk and in the pancreas of the embryo were identical electrophoretically. The amylase occurs mainly in the pancreas of the embryo. We think that the increase in amylase activity in the yolk of fertilized eggs during incubation depends upon the accumulation of pancreatic amylase synthesized by the developing embryo in the egg.

Amylase activity increases in the yolk of fertilized eggs during incubation in chickens.

Amylase activity was detected in the egg of chickens. In unfertilized eggs, no change of amylase activity was observed during 22 days incubation, however, in fertilized eggs, amylase activity increased markedly during embryonic development. The increase depended upon an increase of amylase in the yolk, not in the albumen. Isoamylases in the yolk were electrophoretically identical to those in the pancreas of the embryo or the hen.

The mechanism of irritative nystagmus and paralytic nystagmus. A histochemical study of the guinea pig's vestibular organ and an autoradiographic study of the vestibular nuclei.

To establish the difference of mechanism between irritative and paralytic nystagmus, alterations of Na-K-ATPase and succinic dehydrogenase activity in the vestibular sensorineural elements were investigated for 20 guinea pigs, and glucose uptake of the vestibular nuclei for 13 guinea pigs were measured by the [14C]-2-deoxy-D-glucose method. Irritative and paralytic nystagmus were experimentally provoked by introducing K+ into the perilymphatic space. From the results it was concluded that irritative nystagmus is provoked by increased excitability of vestibular sensory cells, while paralytic nystagmus is provoked by decreased excitability. However, the direction of nystagmus was eventually decided by the tonus imbalance between the bilateral vestibular nuclei. The ipsilateral vestibular nucleus was predominant during irritative nystagmus, while the contralateral vestibular nucleus was predominant during paralytic nystagmus.

Effects of propolis on dental caries in rats.

Propolis, the resinous hive product collected by bees, is important in the defense of the hive. The effects of propolis on growth and glucosyltransferase activity of Streptococcus sobrinus 6715, Streptococcus mutans PS14 and Streptococcus cricetus OMZ61 in vitro, and on dental caries in rats infected with S. sobrinus 6715 were investigated. Propolis had antimicrobial activity against S. sobrinus, S. mutans and S. cricetus, and inhibited both water-insoluble glucan synthesis and glucosyltransferase activity. In rats inoculated with S. sobrinus, about half of their fissures were carious, while dental caries was significantly less (p = 0.01) in rats given propolis. Dental caries was markedly decreased by the multiple actions of propolis which had antimicrobial activity, inhibited water-insoluble glucan synthesis, and inhibited glucosyltransferase activity. No toxic effects of propolis on the growth of rats were observed under experimental conditions in this study. These results suggest that propolis can control dental caries in the rat model system.

Effects of prolonged parotid duct ligation, parotidectomy and acute hepatitis of rats on amylase activity.

Amylase activity in the parotid gland was extremely reduced (to 2.4 per cent) by prolonged duct ligation but that in the pancreas and serum as similar to controls. The serum amylase activity of parotidectomized rats was remarkably reduced within a week of surgery, but recovered to approximately the previous level in 4 weeks. The amylase activities in the pancreas and liver were not different between control and parotidectomized rats. The serum amylase activity of rats with acute hepatitis (1 day after administration of D-galactosamine) decreased to 18.5 per cent compared with controls; however, the activity recovered to its original level after 4-7 days. There was no pancreatic amylase in the serum either of parotidectomized rats or those with acute hepatitis. These observations show that the parotid glands may not be the only source of serum amylase. Serum amylase is mainly derived from the parotid gland, but liver may contribute to serum amylase in compensation for the parotid glands.

An electrophoretic polymorphism in salivary amylases (Amy-1) of mastomys (Praomys coucha).

An electrophoretic polymorphism of salivary amylases (Amy-1) in mastomys (Praomys coucha) (MWC, MRJ and MCC strains) was detected. Amylase in MWC or MRJ saliva, which migrated fast toward the anode, was designated as AMY-1A, and that in MCC saliva migrating slowly as AMY-1B. Salivary amylases are controlled by a pair of codominant alleles at a single autosomal locus (Amy-1). No polymorphism was seen in pancreatic amylases (Amy-2). The frequencies of these phenotypes did not differ between the sexes. Some isoamylases were observed and these were different from those in mouse or rat.

[Serial change of perilymphatic potassium ion concentration in the scala tympani after introducing KCl-solution into the guinea pigs' tympanic cavity].

Characteristic nystagmus similar to the Meniere's attack could be observed after introducing KCl solution into the tympanic cavity of guinea pigs. To confirm the fact that this nystagmus was provoked by the high perilymphatic potassium ion concentration, the K+ activity of perilymph was recorded serially through the K+ specific microelectrode inserted into the scala tympani. The rapid increment of K+ activity reached maximum at 120 minutes after introducing KCl solution, and then it decreased gradually to a half of the maximum activity. However, such change of perilymphatic potassium ion concentration was not observed by introducing sucrose solution as control.

[Physiologically active substances in the oral excreta produced by honey bee--effects of royal jelly on silkworm].

The effect of royal jelly on the growth, development, weight of a cocoon and the number of eggs of the silkworm, Bombyx mori, was tested by the use of artificial diets. The growth and developmental speed of the silkworm were quickened by addition of royal jelly. The number of eggs increased markedly by the feeding of raw royal jelly but not of boiled royal jelly.

Intravenous injection of caerulein or cholecystokinin increases the parotid-type and pancreatic-type amylase in the serum of rats.

Caerulein and cholecystokinin (CCK) injection (i.v.) into rats caused about a 2.3- and 1.9-fold increase in serum amylase activity within 2 h, respectively. The increase of amylase activity in the serum caused by pilocarpine or isoproterenol injection (i.p.) was only of parotid-type amylase. Caerulein or CCK markedly increased pancreatic-type amylase, and significantly increased parotid-type amylase in the serum.

Electrophoretic behavior of amylase in mouse: the parotid gland is major source of serum amylase.

Amylase activity in the saliva, salivary glands, serum, liver (perfused and non perfused) and pancreas was assayed and isoamylases were separated by electrophoresis in these organs using C57BR/cdJ and M. m. molossinus (Kor) mice. Amylase isozymes in the saliva, parotid gland, serum and liver were identical in both strains, respectively. Amylase activity in the liver was lower than that in the serum and liver amylase disappeared almost by perfusion. Major serum amylase was released from the parotid gland in intact animals.

Effects of prolonged duct ligation of the rat salivary glands on the activity of trypsin-like protease.

The effects of ligation on body weight, protease activity and hair kynurenine content were observed. The body weights of parotid gland(PT)-ligated and of combined submandibular (SM)-, sublingual (SL)- and PT-ligated rats were much less than those of sham-operated controls. However, the weights of SM,SL-ligated rats were similar to those of controls. The activity of trypsin-like protease in the duct-ligated submandibular gland was significantly reduced to 0.3-0.7 per cent of that in controls. Protein concentration also decreased in the duct-ligated submandibular gland. Kynurenine content in the hair of duct-ligated rats was higher than that in controls.