Preservation of ultrastructure and immunoreactivity in cryosections of brain tissue stored in a sucrose-gelatin solution at freezing temperatures.

We evaluated the preservation of ultra-structure and immunoreactivity in cryosections of central nervous system tissue mounted with and stored in a sucrose-gelatin solution for one month at -20 degrees C or -80 degrees C. The ultra-structure of synaptic structure in these sections was well preserved and comparable to that of freshly cut cryosections. Quantitative analysis of mitochondrial ultra-structure demonstrated gradually lower degrees of preservation in sections stored at -20 degrees C and -80 degrees C compared with that in freshly cut sections. We observed distinct metabotropic glutamate receptor 1 (mGluR1)-immunogold labelling at peri-synaptic sites in freshly cut sections and also in those stored at -20 degrees C and -80 degrees C. Quantitative analysis of mGluR1 immunoreactivity revealed that the total number of immunogold particles per synapse and the number of non-specifically bound particles were similar under all three conditions. However, the percentage of gold particles bound to a specific synaptic region was greatest in freshly cut sections (79.0%) and progressively lower in sections stored at -20 degrees C (76.1%), in which sections were not frozen, and in sections stored at -80 degrees C (68.0%). These data indicate that ultra-thin cryosections may be conveniently stored in a sucrose-gelatin solution at -20 degrees C for cryoultramicrotomy-immunolabelling.

[Severe thrombocytopenia induced by radiographic non-ionic contrast medium].

A 70-year-old man was admitted to our hospital because of right hemiparesis. He had no allergies or previous exposure to radiographic contrast medium, and the platelet count on admission was within the normal range. On day 8 of hospitalization, he underwent computed tomography of the brain with 100 ml of iopamidol administered intravenously. Three hours later, his platelet count fell to 5,000/microliter, and he developed purpura. Because drug-induced thrombocytopenia was suspected, platelet transfusion was undertaken and corticosteroids were administered. The platelet count returned gradually to normal in 2 days. At the time, we were unable to ascertain the cause of the thrombocytopenia. To clarify whether the contrast medium had been responsible, iopamidol was added to the patient's heparinized whole blood. Subsequent platelet aggregation was observed microscopically and the platelet count decreased, suggesting that the thrombocytopenia had been due to contrast medium-induced platelet aggregation. Although thrombocytopenia after injection of contrast medium is extremely rare, such cases should be evaluated carefully because the condition can be life-threatening if severe.

Slowly progressive insulin-dependent diabetes mellitus in an elderly patient with Graves' disease.

We report a case of slowly progressive insulin-dependent diabetes mellitus in an elderly patient with Graves' disease. A 69-year-old man presented with apathetic thyrotoxicosis and weight loss. Laboratory findings indicated insulin-dependent diabetes mellitus (IDDM) with Graves' disease. Human leukocyte antigens DR4 and DR9, which are recognized as markers for IDDM with autoimmune thyroid disease, were detected. The clinical course of the IDDM was compatible with the slowly progressive type. Onset of this disease during old age is rare, and such cases should be analyzed with a thyroid function test because the symptom of thyrotoxicosis may be masked in the elderly.

A case of advanced esophageal cancer showing a long-term complete response with chemotherapy with nedaplatin alone.

We describe a case of advanced esophageal cancer treated successfully by chemotherapy with nedaplatin alone. A 60-year-old male with type 2 advanced esophageal cancer, which was located in the upper part of the esophagus and had invaded adjacent organs, was treated with nedaplatin 150 mg/body (100 mg/m2) given intravenously every 4 weeks from January 6, 1991. He achieved a partial response (PR) and was discharged in March 1991. Subsequently, he received nedaplatin 75 mg/body in an out-patient setting almost every month until August 1992. Toxicities were tolerable and included mild thrombocytopenia and nausea/vomiting. From serial evaluation in October 1993, the esophageal tumor was not observed. After 7 years since initial chemotherapy was administered, he still survives without the disease.

Intraileal carbohydrate regulates canine postprandial pancreaticobiliary secretion and upper gut motility.

BACKGROUND & AIMS: The effect of nutrients in the distal small intestine or colon on postprandial upper gut function is incompletely understood. The aim of this study was to determine if carbohydrate in the ileum or proximal colon of dogs affects postprandial pancreaticobiliary secretion, gastrointestinal transit, and circulating concentrations of certain gastrointestinal regulatory peptides. METHODS: Seven dogs were prepared with permanent infusion and aspiration catheters in the duodenum and ileum and an infusion catheter in the cecum. Coincident with eating a meal containing liquid and solid markers, ileal or colonic (n = 5 dogs for each) infusion were begun of isosmolar 0.9% NaCl or carbohydrate in a 3:1 ratio of starch to glucose. Pancreatic enzyme output, bile acid delivery, gastrointestinal polypeptide, and plasma concentrations of pancreatic polypeptide, neurotensin, and peptide YY were measured for 6 hours postprandially. RESULTS: Carbohydrate infusion in the ileum, but not in the proximal colon, increased amylase secretion and plasma peptide YY, slowed gastric emptying of liquids and solids, slowed small intestinal transit, and decreased bile acid delivery into the duodenum (P < 0.05 in each). CONCLUSIONS: Carbohydrate in the ileum regulates postprandial exocrine pancreatic enzyme secretion and other postprandial upper gut functions. Peptide YY may play a role in this regulation.

[Effects of ileal perfusion of carbohydrates on upper GI motility and pancreatic exocrine secretion].

The aim of this study was to determine if upper gut function and pancreatic exocrine secretion are affected by the presence of unabsorbed carbohydrate in the distal ileum. In this investigation, starch or glucose was perfused into the canine ileum. This study showed that ileal perfusion of both starch and glucose delayed gastric emptying and prolonged small bowel transit time. Furthermore, glucose had greater effects on gastrointestinal transit time than starch. In contrast, amylase output was increased by ileal perfusion of starch, but was not affected by that of glucose. Our results suggest that the ileal regulation of gastrointestinal transit and amylase output could be mediated by different mechanisms.

Prognostic evaluation of early detection of relapse in adult acute leukemia.

A criterion was established in a previous study to detect the relapse of adult acute leukemia in its early stage, i.e., when lymphocytes in peripheral blood increased over 45% of the leukocytes during the maintenance therapy, bone marrow puncture was immediately performed to examine the leukemic cells. By this criterion the relapse was detected earlier than by other criteria. To study the effect of early detection of the relapse in adult acute leukemia on the results, the second remission rate and the survival time were compared between the following groups. Group I consisted of 11 patients, whose relapse was determined by our criterion. Group II consisted of 8 patients whose relapse was determined by the appearance of leukemic cells in peripheral blood. The second remission was accomplished in 7 of 11 patients in Group I (64%) and in 1 of 8 in Group II (13%) (p less than 0.05). The mean (+/- S.D.) duration of complete remission in Group I was 9.7 +/- 7.8 months and not significantly longer than the value in Group II (5.3 +/- 3.9 months). The interval from relapse to death was 10.3 +/- 5.9 and 6.1 +/- 3.8 months in Groups I and II, respectively. The interval from relapse to death of 7 patients who accomplished the second remission in Group I was 12.5 +/- 5.5 months. This interval was significantly longer than in Group II (p less than 0.02). The mean survival time was 22.2 +/- 9.6 months in Group I and 13 +/- 2.5 months in Group II. The mean survival time of 7 patients accomplished the second remission in Group I was 26. 7 +/- 9.4 months which was significantly longer than in Group II (p less than 0.01). The results showed that our criterion to detect relapse in the early stage was effective for prolongation of the survival time in adult acute leukemia.