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Plasma concentrations and hemodynamic effects of olprinone were evaluated in seventeen patients undergoing open heart surgery. The patients were randomized into the bolus group (15 micrograms.kg-1 bolus dose +0.1 microgram.kg-1.min-1 infusion, n = 9) and the non-bolus group (0.1 microgram.kg-1.min-1 infusion, n = 8). Plasma concentrations and hemodynamic variables were measured before CPB (cardiopulmonary bypass; baseline), 5, 60 min after weaning from CPB, and 3, 6 hours after the end of surgery. Plasma concentrations in the non-bolus group were significantly lower than those of bolus group at any point except for 3 hours after the end of surgery. In the bolus group, increases in the cardiac index and stroke volume index were significantly higher compared with the non-bolus group. From these results we conclude that olprinone given in bolus (15 micrograms.kg-1) followed by continuous infusion (0.1 microgram.kg-1.min-1) is efficacious and safe during weaning from CPB.

We encountered a complete ectometopic suture in a 91-year-old Japanese male cadaver during a gross anatomy course. It was observed in one of 26 skulls aged from 62 to 92 years and was about 13 cm in length from the bregma to the nasion. It is rare to encounter the metopic suture in a person of advanced age, as in the present case.

We encountered two cases of duplication of the inferior vena cava (IVC) in the Japanese cadavers of a 91-year-old man and a 71-year-old woman. Both of the anomalies were classified as Type BC and as Type I according to the systems of Chuang et al. (1974) and of Sarma (1966), respectively. In one case the right IVC was twice the diameter of the left IVC, and in the other it was five times as large. We discuss the clinical importance and the development of duplication of the IVC.

In order to help to organize the understanding of the bewildering complexities of the innervation of the mammalian heart by the vagus nerve and to clear up of confusions as regards the vagus cardiac branches, we scrutinized these branches in the adult house shrew, Suncus murinus, under a stereomicroscope. A number of branches were given off from the vagus nerve not only to the heart, but also to the adjoining great vessels, both outflowing and inflowing. When compared from the developmental viewpoint, the basic conformations of these branches on two sides were found not to differ from each other, but rather presented a symmetrical configuration, the feature which has been ascertained also in mammalian embryos. Relying on developmental criteria, we classified them into the arterial porta-related and the venous porta-related groups, formulating a new terminology by naming them on the basis of their destination. This version of terminology allowed us to define the vagus cardiac branches of the house shrew more accurately than the current terminology (e.g., Nomina Anatomica), and seems to provide us a clue for clearing up confusions concerning the terminology of the vagus cardiac branches in mammals.

This is the first report providing detailed description on an aberrant branch (AB) which, arising from the superior laryngeal nerve (LN), passes through the thyroid foramen and is distributed to the mucous membrane of the larynx. The foramen was observed in 7 out of 14 Japanese cadavers examined in this study, 3 on the right, 3 on the left and one on both sides. In these 7 sides, the AB was given off from the external branch of the superior laryngeal nerve (LN) during its descent on the inferior constrictor muscle of the pharynx. In one side, however, it arose from both the external and internal branches of the superior LN. In each case, the AB, after passing through this foramen, reached the lateral aspect of the arytenoid cartilage, dividing into a superior and an inferior division. The superior one was communicated with a branch of the internal branch of the superior LN, while the inferior one was communicated with that of the inferior LN of the recurrent LN. The joined branches were distributed to the mucous membrane covering the ventricle of the larynx and the vocal fold. On the basis of the height of its distribution, it can be mentioned that the AB is situated intermediate in position between the internal branch of the superior and inferior LNs.

We encountered three anomalies in which the musculocutaneous nerve did not penetrate the coracobrachialis during a gross anatomy course in 1996. Two of the anomalies were present in the bilateral arms of the cadaver of an 89-year-old woman, and the other in the right arm of the cadaver of a 64-year-old man. In all of the anomlies the musculocutaneous nerve, the lateral cord of the brachial plexus, and the median nerve were contained in a common sheath of connective tissue. Thus, muscular branches to the flexor muscles of the upper arm and the lateral antebrachial cutaneous nerve seemed to arise from the cord and the median nerve. After the common sheath was removed, the musculocutaneous and median nerves were completely separated, or the fusion between the musculocutaneous and median nerves only remained partially. These variations are apparently not rare, and it is possible that the combined paralysis of the musculocutaneous and median nerves would occur. The present variation may be important to clinicians.

We encountered a rare anomaly in the cadaver of a Japanese woman in the medical cord of the brachial plexus including the ulnar nerve and the medical root of the median nerve was sandwiched with the axillary and the superficial brachial arteries. The axillary artery passed inferior and dorsal to the medial cord, branching off the subscapular, anterior circumflex humeral arteries, and the common trunk of the posterior circumflex humeral and profunda brachii arteries, and ended as the inferior ulnar collateral artery. The superficial brachial artery descended ventral to the median nerve and divided into the radial and ulnar arteries in the cubital fossa. We discuss the developmental formation of this anomaly.

The cryopreservation of hematopoietic stem cells can be used for rescuing the hematopoiesis after high dose chemotherapy.The ice crystal formation during the freezing procedure is the key point that can be harmful to the cells. The cryopreservation of hematopoietic stem cells in a controlled-rate freezer could decrease the cell damage.Twenty-three patients with a median age of 26 years (range 03-57) had bone marrow and/or peripheral blood stem cells harvested from March 1993 through October 1994, ending up to 86 freezing procedures. The patient's diagnoses are as follows: Non-Hodgkin's Lymphoma (n = 5); Acute Myelogenous Leukemia (n = 8); Acute Lymphocytic Leukemia (n = 6); Hodgkin's disease (n = 3); Multiple Myeloma (n = 1). The cells were frozen away in a controlled-rate freezer chamber at the following rate: -1 degree C/min from room temperature to -45 degrees C and then, at -10 degrees C/min down to -80 degrees C. After freezing, the cells were kept into mechanical freezers until the marrow infusion. To mobilize PBSC (peripheral blood stem cells), G-CSF (granulocyte colony stimulating factor) was given.A median of 3.16 x 10(8) cells/kg (range 0.86-24.22) of PBSC and 2.03 x 10(8) cells/kg (0.19-12.21) of bone marrow cells were frozen. The median time to reach granulocytes greater than 500/microL and platelets greater than 20,000/microL was 12 days (range 8-40) and 31 days (range 8-80), respectively. All patients had marrow engraftment after infusion of hematopoietic stem cells.The cryopreservation procedure using a controlled-rate freezer can store hematopoietic stem cells and potentially, cause less damage to the cells.

Myotonic dystrophy involves not only voluntary muscles of extremities, pharyngeal muscle and respiratory muscle but also smooth muscle in the gastrointestinal tract. This muscle involvement can cause difficulty in excreting sputa, delayed emptying time of stomach and regurgitation of gastric content, all of which can lead to disastrous complications of anesthetic management. Pregnancy is rare because of ovarian atrophy. We report two cases of cesarean section for patients with myotonic dystrophy. In one case, the newborn baby had dyspnea due to congenital myotonic dystrophy, and in another case, patient experienced postoperative pneumonia. Our cases and other reports suggest that spinal or epidural anesthesia is safely applied for a cesarean section of a patient with myotonic dystrophy.

The principal aim of this study was to elucidate key features of the inferior phrenic vein (IPV) of adult rats to determine whether the IPV has the potential to function as a collateral return route conveying blood from the lower portion of the body to the heart, bypassing the subhepatic vein segment of the inferior caval vein. In rats, the IPVs on both sides were found to reveal a symmetric appearance. They were both composite vessels, being made up of two fellow subvessels, the sternocostal and the lumbocostal veins, which in turn anastomosed in tandem in their periphery with each other, formed a collateral route bridging the interval between the suprarenal and the hepatic vein segments of the inferior caval vein. In rat embryos of E17.5, the sternocostal and lumbocostal veins of the IPV were observed to have been well developed, forming tandem anastomoses more clearly than in adults, thus connecting the subcardinal vein to the hepatic vein segment of the inferior caval vein. This fact substantiates our supposition that the rat's IPV originally has the potential to act as a collateral returning route which allows blood to bypass the subhepatic vein segment of the inferior caval vein.

Wistar female rats were injected with testosterone (T) or 5β-dihydrotestosterone (5β-DHT) for the first 5 days of life. Neonatal treatment with 1 mg of T resulted in anovulatory persistent oestrous syndrome in 100% of the animals. In the females injected with 1 mg of 5β-DHT, 74% of the treated rats became sterile at 120 days of age. In addition, 0.5 mg 5β-DHT was also effective in inducing anovulatory persistent oestrus; the incidence of sterility was 10 and 80% at 60 and 120 days of age, respectively. When daily dose of 5β-DHT was reduced to 0.1 mg, however, only 33% of the rats resulted in sterility. These results suggest that the free form of T and non-aromatizable androgen, 5β-DHT, can permanently suppress the development of female type of neuroendocrine regulation. The possible participation of the process other than the central aromatization in androgenization will be discussed.

In 2-day-old female rats, vertical cuts were placed in the brain by means of a knife made of 3 mm-wide razor blade at a level between the rostral end of the anterior commissure and the caudal end of the arcuate nucleus. When killed at 60 or 90 days of age, 45 of 47 thus operated rats had corpora lutea in their ovaries, indicating that the ovulatory discharge of gonadotropins from the anterior pituitary had occurred. The remaining 2 rats had polyfollicular ovaries indicative of ovulatory failure. In another series of experiments, the anterior afferents of the mediobasal hypothalamus (MBH) were interrupted in 28-day-old female rats by means of the so-called Halasz knife at the level of the suprachiasmatic nucleus. By 60 days of age, the rats invariably came into persistent estrus with polyfollicular ovaries, showing that the ovulatory discharge of gonadotropins had been inhibited. In the rats operated on neonatally, wounds due to the cuts healed up almost completely, although some reduction in number of neurons was observed along the cuts. By contrast, in the animals operated on at 28 days of age, wounds were filled with connective tissue. Accordingly, it seems likely that the development of the anterior neural afferents to the MBH, which are involved in the cyclic discharge of pituitary gonadotropins, has not yet been completed by the 2nd postnatal day so that the transections carried out at this age exert little influence on the future occurrence of ovarian cycles.

Nuclear volume of the medial and lateral nuclei of the amygdala was investigated in male and female rats. The volume of the medial nucleus in the adult male rat was significantly greater than that of the female rat. Treatment of female rats with estrogen for the first 30 days of postnatal life increased the nuclear size, and the volume became comparable to that of the males. Although there was no significant difference in volume of this nucleus between male and female rats from days 1 (day of birth) to 11, the difference became evident at day 21, and thereafter it persisted. In contrast, the nuclear volume of the lateral nucleus was not different between the two sexes. Estrogen treatment did not influence the volume of the lateral nucleus in the female animals. These data indicate that the nuclear volume is sexually different in the medial nucleus of the amygdala, and its differentiation occurs during the early postnatal period under the influence of the organizational action of sex steroids.

Wistar female rats were injected with testosterone (T) or 5 alpha-dihydrotestosterone (5 alpha-DHT) from the day of birth (= day 1) to day 5. Neonatal treatment with 1 mg of T resulted in anovulatory persistent estrous syndrome in 100% of the animals. In the females treated with 1 mg of 5 alpha-DHT, 88.2% of the treated rats were sterile at 120 days of age. Treatment with 0.5 mg 5 alpha-DHT was also effective in inducing anovulatory sterility, the incidence of sterility being 71.4%. In the females injected with 0.1 mg 5 alpha-DHT, 42.9% of the animals were anovulatory at 120 days of age. These results suggest that non-aromatizable androgen, 5 alpha-DHT, can permanently suppress the development of female type of neuroendocrine regulation.