This study concerns 16 cases with spontaneous subarachnoid hemorrhage (SAH) of unknown etiology experienced in our department during a period from September 1979 through August 1986. SAH was confirmed by computed tomographic scanning (CT) or lumbar puncture. All cases were studied by four or three-vessel study. In the case of three-vessel study, adequate opacification of the posterior inferior cerebellar artery contralateral to the injected vertebral artery was considered as a necessary condition. Panangiography was repeated in all patients one to two weeks after the initial study and was negative. The severity of SAH in these patients on admission was relatively mild (Hunt and Kosnik grade I + II = 75%), and the degree of subarachnoid bleeding on CT was also mild. Medium to long-term outcome was excellent or good in 81% of cases, and none of them experienced rebleeding. Only one patient died of severe vasospasm on the 20th hospital day, but no aneurysm was found at autopsy. Illustrative 3 patients in whom the cause of SAH had been finally found was briefly reported. In the first patient, SAH was secondary to a paraventricular cryptic angioma. In the second patient, a microaneurysm had been concealed at the initial angiography by the parent arteries or intra-aneurysmal clot. In the third case of a fusiform aneurysm of the vertebral artery, the aneurysm proximal to the posterior inferior cerebellar artery could not be found at the first three-vessel angiography. Importance of CT and the necessity of repeat panangiography including magnification or oblique views so as not to over-look the causative vascular abnormalities were emphasized.

Adult↗

PubMed1988

[A study of continuous cerebrospinal fluid drainage in patients with subarachnoid hemorrhage].

The influences of continuous cerebrospinal fluid (CSF) drainage on vasospasm and hydrocephalus were analyzed retrospectively in 150 patients with subarachnoid hemorrhage (SAH) due to ruptured intracranial aneurysms (32 cases of grade 1, 85 cases of grade 2, and 33 cases of grade 3 by the Hunt and Hess classification). One hundred and seven of these cases received CSF drainage (cisternal, ventricular, lumbar, or a combination of these). The volume of CSF drainage within the first week after onset was 975 +/- 513 ml (mean +/- SD). The total volume of CSF drainage was 2063 +/- 1635 ml (mean +/- SD). The duration of CSF drainage was 10.6 +/- 6.8 days (mean +/- SD). Ten of 46 cases given no drainage within the first week after onset, nine of 55 cases with a drainage volume of less than 1000 ml within the first week, and 24 of 49 cases with a drainage volume of more than 1000 ml within the first week showed vasospasm. There was a statistically significant dose-response (drainage volume-vasospasm) relationship (p less than 0.005, Mantel extension method). Four of 43 cases with no drainage, 26 of 67 cases with a total drainage volume of less than 2000 ml, and 24 of 40 cases with a total drainage volume of more than 2000 ml developed hydrocephalus. There was a statistically significant dose-response (drainage volume-hydrocephalus) relationship (p less than 0.005, Mantel extension method). Vasospasm and hydrocephalus were statistically associated (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1988

[A study of cisterna magna on brain computerized tomography in children].

Although many publications on cranial computerized tomography have been reported in recent years, very little attention has been directed to the cisterna magna (CM) and its variations. The size of the cisterna magna is still debatable and the criterion of the mega cisterna magna is obscure. We studied age distribution, clinical manifestations, and other CT findings in the children with enlarged cisterna magna. A consecutive series of 367 computerized tomographic scans were reviewed. We classified four classes according to the degree of enlargement of the cisterna magna: CM is undetectable; CM (-), CM is detectable at the level of sella turcica and the fourth ventricle; CM(+), CM extends upward at the level of suprasellar cistern and colliculus inferior; CM (+ +), and CM extends extensively at the level of the third ventricle and colliculus superior; CM (+ + +). We judged 55 CT scans (15%) to belong to CM (+ + +) class and 100 scans (27%) to CM (+ +) class. The greater part of children with CM (+ + +) were younger in contrast with CM (+ +), which distributed uniformly in every ages. Also we differentiated the patients into three groups from clinical manifestations as follows: patients with developmental delayed; group D, patients with organic neurological diseases; group N, patients with other diseases; group O. The ratio of group D is significantly higher in CM (+ + +) than that of other groups. No children had posterior fossa symptoms of mass effect and required treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1988

A "give" in tension and sarcomere dynamics in cardiac muscle relaxation.

Isometric relaxation in cardiac sarcomeres is characterised by an early, very slow phase of tension fall which is terminated by a 'give' in tension. A 'give' which occurs during relaxation in cardiac muscle can not be attributed to decrease in myofilament overlap. After the 'give' asynchronous motion occurs between sarcomeres, but the duration and extent of their displacement is limited. Intriguingly, the effect of isotonic displacements on the early fall in the velocity of sarcomere shortening indicates that an internal resistance increases near the peak of contraction. The complex shape of the sarcomere's complete force-velocity relation, with lengthening motions in particular, was consistent with an idealized model of cross-bridge cycling. The sarcomere's resistance to stretch is high at low velocity, but it diminishes to reveal yielding at larger velocities. Relative to tension, the resistance to yielding does not decrease during relaxation, and it may actually increase. The decay of isometric tension after a controlled stretch also slows during relaxation. Consequently, cycling slows in those cross-bridges which form (or persist but produce less force) later in contraction. Changes in cross-bridge properties may restrict sarcomere shortening, prolong activation, but promote a disequilibrium which favors rapid relaxation in cardiac muscle.

Animals↗

PubMed1987

Chromatographic profiles of urinary isoenzymes in healthy children.

Urinary excretion of alkaline phosphatase, gamma-glutamyltransferase and lactate dehydrogenase was studied in a carefully selected group of 155 healthy children, 83 females and 72 males. Enzyme activity was assayed in randomly collected urine samples after gel filtration of the urine specimens. On chromatograms, urinary enzymes of alkaline phosphatase, gamma-glutamyltransferase and lactate dehydrogenase were separated into 4, 2 and 5 isoenzymes, respectively. Mean values of alkaline phosphatase, gamma-glutamyltransferase and lactate dehydrogenase activity were 4.59, 21.6 and 10.0 U/g creatinine. There were no sex-related differences besides lactate dehydrogenase which showed a higher excretion in females than in males. The excretion of urinary enzymes clearly decreased with increasing age.

Adolescent↗

PubMed1987

Inhibition of gastric acid secretion by human calcitonin gene-related peptide with picomolar potency in guinea-pig parietal cell preparations.

The effect of CGRP on [14C]-aminopyrine accumulation in isolated parietal cell preparations from guinea-pig fundic mucosa was studied. Parietal cells consisted of 60% of the preparations. [14C]-Aminopyrine accumulation was used as an index of physiological response of parietal cells to secretagogues. CGRP dose-dependently (10(-12)-10(-9) M) inhibited parietal cell aminopyrine accumulation stimulated by histamine (10(-4) M), carbachol (10(-4) M), and pentagastrin (5 X 10(-6) M). The concentration of CGRP exerting half-maximal inhibition of [14C]-aminopyrine accumulation was 8.7 X 10(-11) M for histamine, 9.1 X 10(-11) M for carbachol, and 4.7 X 10(-11) M for pentagastrin. The inhibitory effect was much more potent than cimetidine, pirenzepine or benzotript. CGRP but not cimetidine inhibited DBcAMP stimulated aminopyrine accumulation (IC50 = 7.5 X 10(-11) M). These results suggest that CGRP may exert its inhibitory action on gastric acid secretion by a direct action on the parietal cell or the somatostatin-producing D cell.

Aminopyrine↗

PubMed1987

Characterization of picomolar affinity binding sites for [125I]-human calcitonin gene-related peptide in rat brain and heart.

We have characterized picomolar affinity binding sites for human calcitonin gene-related peptide (CGRP) in rat brain and heart (atria and ventricle) membranes. By saturation analysis, apparent dissociation constant (KD) values of high affinity sites for [125I]-human CGRP are 9 approximately 15 pM (brain), 34 pM (ventricle) and 85 pM (atria). Low affinity sites with KD values of about 50 nM are found in rat brain and ventricle, but not in atria. Human and rat CGRP potently inhibited [125I]-human CGRP binding to these high affinity sites with apparent inhibition constant (Ki) values comparable to their KD values. Salmon calcitonin marginally inhibited these binding with Ki values between 0.1 microM and 1 microM. Extremely potent cardiovascular and gastrointestinal actions of CGRP might be mediated through CGRP binding sites with picomolar affinity which are similar to those we characterized in this study.

Animals↗

PubMed1987

Novel Leu-Lys-specific peptidase (Leulysin) produced by gel-entrapped yeast cells.

Saccharomyces cerevisiae cells entrapped with a neutral hydrophilic photo-crosslinkable resin prepolymers specifically excreted into a cultured medium a new type of a peptidase, which cleaved Leu-Lys bond of alpha-mating factor. The enzyme was purified by membrane filtration followed by ion exchange chromatography and gel filtration chromatography. The purified enzyme showed a strict substrate specificity on internal Leu-Lys bond. Leu-Lys bond near terminus of a molecule and Leu-X and X-Lys bonds examined so far were not hydrolyzed by the enzyme.

Amino Acid Sequence↗

PubMed1987

Class-specific regulation of anti-DNA antibody synthesis and the age-associated changes in (NZB x NZW)F1 hybrid mice.

Investigations of regulatory helper and suppressor T cells in the in vitro anti-DNA antibody synthesis in NZB x NZW (B/W) F1 hybrid mice were initiated by the development of an in vitro system in which G10-passed B cells from B/W F1 mice were cocultured with mitomycin C-treated T cells in the presence of Con A and either in the presence or in the absence of LPS. It was revealed that each IgG and IgM anti-DNA antibody synthesis was under the regulation of separate L3T4+ helper and Ly-2+ suppressor T cells. The function of these class-specific regulatory T cells was age-dependent. Although the helper effect of L3T4+ T cells on IgG antibody synthesis increased, the effect of L3T4+ T cells on IgM antibody production decreased in B/W F1 mice with aging. The IgG anti-DNA antibody production in the cocultures of L3T4+ T cells and B cells was suppressed by addition of Ly-2+ T cells from young but not aged B/W F1 mice, whereas the production of IgM anti-DNA antibodies was suppressed by Ly-2+ T cells from aged but not young B/W F1 mice. We also found that although IgM anti-DNA antibody-producing B cells were already present in 2-mo-old mice, B cells producing IgG antibodies under the influence of L3T4+ T cells appeared in mice at 7 mo of age. These data clearly indicate that separate class-specific regulatory T cells are involved in the production of IgM and IgG anti-DNA antibodies and that the total serum level of the antibodies is reflected by both their age-associated changes and the generation of antibody-forming B cells in B/W F1 mice.

Aging↗

PubMed1987

Automated separation and measurement of urinary isoenzymes and protein by ion-exchange liquid chromatography.

This paper deals with a totally automated detection system for the assay of urinary isoenzymes and protein using high-performance liquid chromatography with a continuous post-column detection system. We attempted to determine the distribution of three enzymes in urine samples from a healthy child and in tissue extracts of rabbits. Alkaline phosphatase, gamma-glutamyltransferase and lactate dehydrogenase isoenzymes were each separated into six peaks. In comparison with the previous methods, this procedure provides better precision and accuracy, and it is sufficiently sensitive to allow the analysis without preconcentration of urine samples.

Alkaline Phosphatase↗

PubMed1987

Acute effects of 1-methyl-4-phenylpyridinium ion (MPP+) on dopamine and serotonin metabolism in rat striatum as assayed in vivo by a micro-dialysis technique.

The acute effect of 1-methyl-4-phenylpyridinium ion (MPP+), a neurotoxin derived from 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), was examined by the in vivo micro-dialysis technique. A dialysis cannula was implanted into rat striatum, and the changes in the concentrations of dopamine (DA), 3, 4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA), and 5-hydroxyindoleacetic acid (5-HIAA) in the perfusate every 20 min after administration of MPP+ were determined by high-performance liquid chromatography with electrochemical detection (HPLC-ED). After MPP+ administration the levels of DOPAC, HVA and 5-HIAA were markedly decreased. On the contrary the level of DA was markedly increased and reached a maximum 40 min after beginning of the MPP+ administration. By postmortem analysis of the striatal tissue MPP+ was proved to cause the inhibition of monoamine oxidase (MAO), especially MAO-B. These results suggest that the acute biochemical changes induced by MPP+ in vivo were MAO inhibition and release of DA.

1-Methyl-4-phenylpyridinium↗

PubMed1987

Alterations of monoamine metabolites and of tryptophan in the basal cisternal CSF of patients after subarachnoid haemorrhage.

Homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA) and tryptophan (TRP) were measured in the CSF obtained from the basal cistern of 20 patients, who had undergone surgical obliteration of bleeding aneurysms within 3 days after subarachnoid haemorrhage (SAH). The concentrations of these substances, which were assayed by high performance liquid chromatography (HPLC), were the highest on days 3 or 4, and thereafter showed a gradual decrease with an increase in time. The cisternal CSF in patients who had severe preoperative clinical grades of SAH or vasospasm contained relatively higher concentrations of HVA, 5-HIAA and TRP than those contained in patients who did not. It is proposed that SAH stimulates the release of monoamines from the brain with the resultant extracellular accumulation of their metabolites and their diffusion into CSF during the acute stage. This stimulatory effect of SAH on the brain monoamine system may be consistent with those previously reported in cases of cerebral haemorrhage or infarction.

Female↗

PubMed1987

Intraosseous lipoma of the skull: a report of two cases.

Case histories of a 12-year-old boy and a 20-year-old woman with hyperostosis of the frontoparietal bones are presented. Microscopical examination of the lesions showed intraosseous lipoma with hyperostosis of diploë. In both cases, only the prominent part of the tumor was removed for cosmetic reasons. The results were satisfactory, and there was no evidence of recurrence over a period of six years.

Adult↗