Glucose intolerance and insulin hyperreaction after oral glucose loading have been reported in various liver diseases. Pancreatic hypersecretion and decreased hepatic degradation of insulin have been pointed out as explanation of the high peripheral insulin levels. To clarify the effects of and correlation between these two factors in various stages of liver diseases, serum immunoreactive insulin (IRI), connecting peptide immunoreactivity (CPR) and blood glucose (BG) were determined after 50-g oral glucose tolerance tests. In the acute stage of acute hepatitis, ΣCPR, ΣCPR/ΣBG and ΣIRI/ΣCPR were high, suggesting that both increased secretion and decreased degradation of insulin were responsible for the high peripheral insulin levels. In the convalescent stage, ΣCPR, ΣCPR/ΣBG and ΣIRI/ΣCPR were normal. In chronic hepatitis, increased ΣCPR and normal ΣCPR/ΣBG were observed. ΣIRI/ΣCPR was low in chronic persistent hepatitis, but high in chronic aggressive hepatitis. Thus, in chronic persistent hepatitis, hypersecretion of insulin to compensate for the elevated blood glucose was induced and insulin degradation did not decrease, so that normal peripheral insulin levels were maintained. In chronic aggressive hepatitis, increased secretion and decreased degradation of insulin were responsible for the higher peripheral insulin levels. In compensated liver cirrhosis, ΣCPR and ΣCPR/ΣBG were high, but ΣIRI/ΣCPR was normal. In the decompensated state, ΣCPR was high, ΣCPR/ΣBG normal and ΣIRI/ΣCPR high, suggesting that increased insulin secretion was the major cause of the high peripheral insulin levels in compensated liver cirrhosis. In the decompensated state, both increased secretion and decreased degradation of insulin were responsible for the high peripheral insulin levels. These data indicate that insulin secretion from the pancreas and insulin degradation in the liver are influenced by the stage of the liver disease.
In liver diseases, it has been pointed out that pancreatic hypersecretion of insulin is one of the factors which induces hyperreaction of serum insulin after oral glucose loading. Insulin secretion may change according to the stage of liver injury. To address this problem, the glucose tolerance test (GTT) and perifusion of the islets of Langerhans were performed in rats with carbon tetrachloride (CCl4)-induced liver injury. On the day after administration of CCl4, ΣIRI increased after GTT, but decreased after perifusion. On the 3rd and 7th days, ΣIRI after GTT and perifusion was normal. These results suggest that in the acute stage of acute liver injury, pancreatic secretion of insulin was reduced and hyperreaction of serum insulin to GTT was probably due to decreased insulin degradation. In the convalescent stage, insulin secretion was normal. During the 3 to 6 weeks of CCl4 administration, ΣIRI in GTT and perifusion rats did not differ significantly from that of controls. But in the 12th week, ΣIRI after GTT and perifusion increased remarkably. These results suggest that in the early stage of chronic liver injury, pancreatic secretion of insulin does not change, but in the cirrhotic stage, insulin secretion increases, causing hyperreaction of insulin after GTT.
The lysostaphin sensitivity test of staphylococci is a reliable classification method based on the differences in peptidoglycan compositions. Lysostaphin sensitive staphylococci are identified as S. aureus. In this paper, we stueied the applicability of this test to the rapid classification of clinically isolated staphylococci. Staphylococci were exposed to 2μg of lysostaphin per ml at 37°C for 15min. The sensitivity was decided by a turbidity check and gram-stain check. There were no differences between the check methods. Sixty-four strains of 99 clinical isolates were sensitive and consisted of 59 S. aureus. strains and 5 non-S. aureus strains (S. simulans 4; S. capitis 1). The 35 strains which were lysostaphin-insensitive were non-S. aureus as identified by coagulase and other biological sensitivity tests. The lysostaphin sensitivity test might be a very reliable and rapid method for the identification of S. aureus.
Effects of intra-hippocampal administration of gabaculine, a GABA aminotransferase inhibitor, on kindled amygdaloid seizure were examined in rats. In addition, changes in regional brain GABA content after gabaculine administration were determined. Intra-hippocampal administration of gabaculine has a dose-dependent anticonvulasnt effect on kindled amygdaloid seizure. The anticonvulsant effect of gabaculine (0.92μg/2μl) was observed within only 24 hours of the gabaculine administration. Further, a significant increase in the GABA level in the ventral mibdrain region was observed within only 24 hours of the gabaculine (0.92μg/2μl) administration. The suppression of amygdaloid kindled seizures after intra-hippocampal administration of gabaculine may be due to the elevation of the GABA level in the ventral midbrain rather than in the hippocampus.
Fifteen years have passed since the speech correction class was established at Izushi Primary School in Okayama. Of the 2252 children who studied in this class, 737 finished the curriculum. This class has played an important role in the education and rehabilitation of speech handicapped school children. The author introduced the history of this class and presented the recent problems.
A problem of Pancreatic CT scanning is the discrimination between the pancreas and the adjacent gastrointestinal tract. Generally we administer a dilution of gastrografin internally to make the discrimination. The degree of dilution has been decided by experience at each hospital. When the consistency of the contrast medium is low in density, an enhancement effect cannot be expected, but when the consistency is high, artifacts appear. We have experimented on the degree of the dilution and CT-No to decide the optimum consistency of gastrografin for the diagnosis of pancreatic disease. Statistical analysis of the results show the optimum dilution of gastrografin to be 1.5%.
Serum ferritin levels were determined in 75 hematologic, 1205 malignant, and 538 benign diseases. In hematologic diseases the serum ferritin level was generally low in iron deficiency anemia, but high in hemochromatosis, aplastic anemia, and leukemia. In malignant diseases the serum ferritin concentration was increased remarkably in lung, liver, biliary, and urogential diseases and in malignant lymphoma. Among benign diseases hepatitis cases showed a tendency for high serum ferritin levels. Serum ferritin levels are influenced by various factors, and their careful evaluation may be essential for understanding of the underlining disease process.
T-lymphocyte subsets in bronchoalveolar lavage fluid (BALF) were examined to study immunological abnormalities in the lung of bronchial asthma patients. T-cell subsets were determined by immunofluorescent microscopy using OKT monoclonal antibodies: T3 for pan T-cells, T4 for helper/inducer cells, and T8 for suppressor/cytotoxic cells. In these analyses, patients with bronchial asthma were classified according to the background of atopy, onset age, and duration of asthmatic symptoms. Decreased T4 percent and T4/T8 ratio were found in patients with non-atopic asthma, patients with onset later than 40 years of age, and patients with a duration of less than 5 years. Although corticosteroids are known to decrease the T4 percent and T4/T8 ratio in peripheral blood lymphocytes, their effect on T-cell subsets in BALF is not well known. In this study, the T4 percent and T4/T8 ratio in BALF were found to be lower in patients with corticosteroids than in patients without corticosteroids and in healthy subjects. These results indicate that an immunological abnormality which might be related to the pathogenesis of bronchial asthma exists in particular groups of asthmatic patients.
Interferon (IFN) is known to be released in viral infection. In addition to the direct effect of inflammation of the respiratory tract, the released IFN is also suspected to be an important factor in the aggravation of bronchoconstriction in bronchial asthma. The effects of IFN on morphological changes of basophils from round to pear shape and histamine release from basophils were analyzed to clarify the role of IFN in bronchial asthma. IFN alone did not affect these parameters in either healthy subjects or asthmatic patients. As a model of the basic bronchial asthma reaction, anti-IgE was added to basophils with and without IFN preincubation. The IgE mediated reaction was enhanced with IFN in basophils from atopic and non-atopic asthma patients. Furthermore, the enhancement of histamine release was observed in atopic asthma, more significantly than in non-atopic asthma. The IgG mediated reaction of basophils is considered to play a role in some asthmatic patients. IFN apparently increased reactive basophils of non-atopic asthma patients in the IgG mediated reaction. On the other hand, the histamine release from basophils was so minimal that the effect of IFN on the IgG mediated reaction was not clearly detected. While the mechanism of enhancement is still controversial, the suppressive effect of histamine release by isoproterenol in addition to anti-IgE suggest the regulation of reactive basophils by the cyclic AMP concentration.
Radiation therapy for bone metastasis of malignant tumors is useful for reducing pain and is often used. Bone scintigraphy is useful for the early detection of bone metastasis and for staging, and is important in making plans for the irradiation of metastatic bone lesions. However, the images of metastatic bone lesions vary, so the irradiation field must be decided by comparison with plain films, computed tomography, and so on.
We have used an NMR-CT scanner clinically since August 1 1984. We report herein the operating pulse sepuences, and present 5 cases of 226 cases that we have examined. From our clinical experience during the past four months, we describe the advantages and disadvantages of NMR-CT. The advantages are that: 1) it is possible to recognize blood vessels without contrast materials and to evaluate the blood flow 2) there are neither bone nor air artifacts, and 3) it is possible to get the tomogram in any direction. The disadvantages are that: 1) the examination time is very long, 2) there are artifacts from ferromagnetic substances placed in the body, 3) when palse sequence is changed, images are different from each other, and 4) because of respiratory motion artifacts, the images of the chest and abdomen are inferior to those of other parts of the body.
Impairments and disabilities of forty-two bilateral lower extremity amputees resistered at the Okayama Prefectural Rehabilitation Center from 1967 to 1983 were analysed. Sixty-nine percent of the amputation were related to trauma. The incidence of amputation due to vascular disorders were lower in Okayama than in Western countries. Sixty percent of the cases ranged from twenty to sixty years of age. The average age of the amputees was lower than that in Western coutries. In eighty-seven percent of the amputees, skin erosion and sweating were major complaints. Therefore, the development of sweat-absorbable sockets is an important project. Lock or safety knee joints were used for A/K prostheses in order to obtain good knee stability. Of six high level amputees, three were confined to a wheel chair. Thirty-nine amputees were able to walk with prostheses. One third of the cases had no job after prosthetic training. Eighty-one percent of all cases were married. The rate of employment and marriage was much higher than in Western countries. From these findings, it can be said that bilateral lower extremity amputees are rehabilitated fairly well in Okayama.
The cyclic AMP contents of cortical slices after incubation with or without agents such as norepinephrine were determined in four areas of rat cerebral cortex in which FeCl2 solution was injected into the unilateral sensorimotor cortex to induce an epileptic focus. Norepinephrine, isoproterenol and phenylephrine elevated the cyclic AMP levels of cortical slices 4- to 7-fold, 2- to 4-fold and 1.5- to 3-fold, respectively. The elicitation of cyclic AMP accumulation by norepinephrine was inhibited by 30 to 60% with phentolamine and 65 to 80% with propranolol. 8-Phenyltheophylline almost completely inhibited the elicitation of cyclic AMP accumulation by a norepinephrine-propranolol combination but not by a norepinephrine-phentolamine combination. In anterior cortical areas of rats in which the appearance of isolated spikes in electrocorticograms was dominant either ipsilaterally or contralaterally to the injection site 8 to 10 days after the injection of FeCl2 solution, the elevated levels of cyclic AMP elicited by norepinephrine, isoproterenol and a norepinephrine-phentolamine combination were higher on the side of dominant spike activity than on the other. In anterior cortical areas of rats showing dominant spike activity on either side of the cortex 31 to 60 days after the injection, the elevated levels of cyclic AMP elicited by norepinephrine and phenylephrine were lower on the dominant side than on the other. In anterior cortical areas of rats showing nearly equal spike activity on the two sides 31 to 60 days after the injection, the elevated levels of cyclic AMP elicited by norepinephrine, isoproterenol and a norepinephrine-phentolamine combination were higher on the side ipsilateral to the injection site than on the other. In these rats, a similar regional difference in the norepinephrine-elicited accumulation of cyclic AMP was detected 19 to 21 days after the injection. In anterior and posterior cortical areas of rats in which the appearance of spike and slow wave complexes as well as isolated spikes were detected 31 to 60 days after the injection, the elevated levels of cyclic AMP elicited by norepinephrine, isoproterenol, phenylephrine and combinations of norepinephrine and phentolamine or propranolol were higher on the side ipsilateral to the injection site than on the other. The tendency for the norepinephrine-elicited accumulation of cyclic AMP to be related to the epileptic discharge patterns in rats 61 to 90 days after the injection was similar to that in rats 31 to 60 days after the injection. The regional differences in cyclic AMP contents of incubated cortical slices are discussed with regard to the neurochemical process of iron-induced epilepsy.
Electrocorticograms (ECoGs) and somatosensory evoked potentials (SEPs) were recorded, and convulsion thresholds were determined in rats in which FeCl2 solution was injected into the unilateral sensorimotor cortex. Isolated spikes appeared immediately after the injection of FeCl2 solution in ECoGs of the cortex near the injection site and the contralateral homotopic cortex. The injection of FeCl2 solution produced different electrocorticographic features in which the frequency of isolated spikes was dominant on the side ipsilateral or contralateral to the injection site or nearly equal on the two sides. The spike frequency increased up to 30 to 50 days after the injection, and then was almost constant in most of the rats up to 90 days after the injection. In rats showing nearly equal spike activity on the two sides, there was a tendency for the spike frequency to decrease gradually after 30 to 50 days. Most of the spike and slow wave complexes appeared bilaterally one month or more after the injection in rats in which the isolated spike activity was dominant on the side ipsilateral to the injection site or nearly equal on the two sides. The proportion of rats showing spike and slow wave complexes increased steeply until three months after the injection, and reached 36% of all the FeCl2 solution-injected rats six months after the injection. In ECoGs of these rats, isolated spikes were also detected. In rats showing dominant spike activity on either side of the cortex, most of spikes appeared unilaterally, while in rats showing nearly equal spike activity on the two sides and those showing spike and slow wave complexes, the frequency of almost synchronous spikes on both sides was higher than that of unilateral spikes. In rats showing dominant spike activity on the side contralateral to the injection site, SEPs recorded at the cortex near the injection site were devoid of the initial positive deflection and were monophasic. They were biphasic in other FeCl2 solution-injected rats. In rats showing only isolated spikes, abnormal behavior was seldom observed, and convulsion thresholds were lowered. In most of the rats showing spike and slow wave complexes, head nodding was observed. The induction and development of epileptic focus by FeCl2 solution are discussed.