Chronic atherosclerotic mesenteric ischemia that started to develop symptoms just after anaphylaxis.

An 83-year-old woman was referred to our emergency department with acute urticaria and sudden shortness of breath approximately 30 min after taking rectal diclofenac potassium for lumbago. After treatment with adrenaline and corticosteroids, the patient became hemodynamically stable and left the hospital on the next day. She attended our hospital 1 week after the onset of anaphylaxis because of repeated postprandial epigastric pain. No abnormal lesions were found in endoscopy. Radiographic selective catheter angiography revealed chronic mesenteric ischemia caused by atherosclerosis and abundant collateral arteries between the celiac trunk, the superior mesenteric artery and the inferior mesenteric artery. Patients with chronic mesenteric ischemia usually present with a clinical syndrome characterized by painful abdominal cramps and colic occurring typically during the postprandial phase. Fear of eating resulted in malnutrition. She was prescribed proton pump inhibitor, digestants, anticholinergic agents, serine protease inhibitors, prokinetics, antiplatelet agents and transdermal nitroglycerin intermittently, but these had no beneficial effects. It was most probable that this patient with chronic atherosclerotic mesenteric ischemia was suffering from functional abdominal pain syndrome induced by anaphylaxis. Since psychiatric disorders were associated with alterations in the processing of visceral sensation, we facilitated the patient's understanding of functional abdominal pain syndrome with the psychologist. Postprandial abdominal pain gradually faded after administration of these drugs and the patient left the hospital. Developing a satisfactory patient-physician relationship was considered more effective for the management of persistent abdominal pain caused by complicated mechanisms.

Role of the locus coeruleus in transmission onto anterior colliculus neurons.

The present study was an attempt to elucidate the role of locus coeruleus (LC) on neuronal activities in the anterior colliculus of rats anesthetized with alpha-chloralose. The spike latency of neurons in the deep grey and white layers of anterior colliculus elicited by stimulation of the optic chiasm (OC), lateral geniculate body (LGB) and visual cortex (VC) was longer than that of neurons in the more superficial layers: optic and intermediate grey layers. When conditioning stimuli were applied to LC, a significant inhibition of spike generation upon OC, LGB and VC stimulation was observed on neurons of deep grey and white layers, but not on those of optic and intermediate grey layers. The conditioning stimulation did not alter spike generation, either in the neurons of deep grey and white layers or those of optic and intermediate grey layers, following stimulation of the superficial grey layer. These results strongly suggest that noradrenaline originating in the LC could produce an inhibition of neuronal activities in the deep grey and white layers, and such is probably the result of inhibition of neurons located in the superficial layer of the anterior colliculus.

The role of thiamine on excitable membrane of crayfish giant axon.

Electrophysiological and biochemical studies were performed to determine the role of thiamine in the excitable membrane of the crayfish giant axons, as it has been suggested that thiamine plays a role in the excitability of the membrane which is unrelated to the metabolic process. Thiamine (5mM) significantly increased the rising rate of the action potential without affecting the resting membrane potential and threshold potential. A recovery of the enhancement was evidenced by a wash of the axon with physiological solution. Pyrithiamine (10 mM) reduced the rising rate of the action potential without affecting the membrane and threshold potential. The reduction of dV/dt by pyrithiamine remained unchanged after a wash of the axon with physiological solution, while dV/dt increased after thiamine treatment. The amount of thiamine found in the crayfish axons was comparable to that observed in the rat sciatic nerve. In addition, pyrithiamine reduced the thiamine content in axons and protein binding thiamine of the axons. It is thus concluded that thiamine in the excitable membrane of crayfish axons plays a significant role in production of the action potential and is essential for maintaining the membrane excitability of crayfish axons.