In vitro production of enterotoxin by Vibrio cholerae, NAG isolated from human diarrheal cases in India, the Philippines and Sudan was tested. Of a total of 41 strains tested, 8 proved to produce the toxin characterized by permeability-increasing activity in the guinea pig skin. Characterization of the toxin produced by a representative strain was also made in comparison with cholera enterotoxin produced by V. cholerae, serotype 1, 569B strain. This toxin was heat labile, nondialyzable and immunogenic. It evoked

In vitro production of enterotoxin and hemorrhagic principle by Vibrio cholerae, NAG.

✓Nelson syndrome (NS) is a rare clinical manifestation of an enlarging pituitary adenoma that can occur following bilateral adrenal gland removal performed for the treatment of Cushing disease. It is characterized by excess adreno-corticotropin secretion and hyperpigmentation of the skin and mucus membranes. The authors present a comprehensive review of the pathophysiology, diagnosis, and management of NS. Corticotroph adenomas in NS remain challenging tumors that can lead to significant rates of morbidity and mortality. A better understanding of the natural history of NS, advances in neurophysiology and neuroimaging, and growing experience with surgical intervention and radiation have expanded the repertoire of treatments. Currently available treatments include surgical, radiation, and medical therapy. Although the primary treatment for each tumor type may vary, it is important to consider all of the available options and select tthe one that is most appropriate for the individual case, particularly in c...

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Nelson syndrome: comprehensive review of pathophysiology, diagnosis, and management.

Induction of preeclampsia like phenomena by stimulation of sympathetic nerve with cold and fasting stress.

To evaluate the effect of cold-induced stress on renal and hepatic blood flow and coagulation parameters, rabbits’ soles were exposed to ice pad (0° C). Renal and hepatic blood flow was measured after 1 h and 15 days of cold stress. Coagulation parameters (0, 8th and 15th days of stress) and histological studies were performed. Renal and hepatic blood flow was significantly reduced after cold-stress. Decreased platelet count, antithrombin III (AT III) activity, increased fibrinogen (Fbg) level, shortened activated partial thromboplastin time (aPTT) and prothrombin time (PT) was found after 8 and 15 days of cold-stress. Histology showed enlarged glomeruli with fibrin deposition in kidney, ischemic changes and fibrin deposition in liver and hemorrhagic necrosis in adrenal cortex. We conclude that undesirable localized cold induced sympathetic stimulation in daily life may be a predisposing factor for coagulopathy.

Induction of Hypercoagulability Condition by Chronic Localized Cold Stress in Rabbits

In this study, we have demonstrated that repeated electrical stimuli to the artery of the mesenteric pedicle can produce mesenteric microcirculatory disturbance by autonomic nervous irritation in rats. The parameters to demonstrate microcirculatory damage were observed and quantitatively analyzed using the intravital microscopy after electrical stimulation for 40 minutes. The blood flow of arterioles and venules in the mesentery showed ischemia-reperfusion pattern during the repeated electrical stimulations. The diameter of arterioles did not show significant change, while RBC velocity of arterioles was significantly decreased at 30 min after the irritation. The RBC velocity in venules was decreased from the early period to about 20%. But this values were not significantly dropped during the later observation period, suggesting the formation of short circuit flow by passing the collapsed capillary beds. The number of rolling WBC in the venules was notably increased at the time immediately after irritation, and thereafter the number of rolling WBC number was rather reduced. The number of sticking WBC in venules was time-dependently increased and reached its maximum at 30 min. When permeability of venular wall was determined by the injection of pontamine sky blue, significant increase in permeability was already shown immediately after irritation, suggesting that the integrity of microvascular wall was disturbed in this early period. The permeated area expanded thereafter in parallel with the increase in sticking WBC number. From these observations, it is suggested that endothelial cell damage and following leukocyte-endothelium interaction induced by autonomic nerve irritation appear to be an important factor in microcirculatory disturbances.

Quantitative analysis of mesenteric microcirculatory disturbances induced by autonomic nervous irritation.

1. Various lesions were produced in the pancreas, stomach, lungs and adrenals by giving nervous irritation directly to the cervical autonomic nerves, coeliac autonomic ganglia or the splanchnic nerve.2. Production of these lesions were prevented or ameliorated by administration of Chlorpromazine or Cortisone in adequate doses or by hypophysectomy, whereas administration of these agents in larger doses, or of ACTH aggravated these lesions.3. These experimental results were interpreted as indicating that irritation given to the organism induces various lesions in various organs through a direct pathway of peripheral autonomic nerves, as well as through that of peripheral autonomic nerve-diencephalon-pituitary-adrenal axis. In other words, both the autonomic nervous system and pituitary adrenal axis are participating cooperatively with each other, in the pathogenesis of Reilly's phenomena as well as in that of Selye's general adaptation syndrome. Finally, the authors wish to stress that these two unspecific phenomena must be summarized and organized theoretically in a category of “agressology.”

Experimental studies on the pathological changes in the several organs due to irritation of the autonomic nervous system

1. In two patiens suffering from urinary retention of various causes, appearance of arrhythmias were seen at the time of overdistension of the urinary bladder, which promptly disappeared by emptying of the bladder by catheterisation.2. Experimental overdistension of the urinary bladder in animals resulted in transitory fall of blood pressure, pictures of coronary insufficiency in EKG and/or appearance of arrhythmias. These changes disappeared by relieving the bladder of overdistension.3. In guinea pigs it was shown that the EKG changes produced by over-distension of the urinary bladder were erased by transection of the spinal cord between the lumbar and sacral segment.4. Using electrophysiological technic, it was shown that the nervous transmission from the bladder wall to the heart was related to vago-vagal reflex.This research was reported at the 11th Congress of the Japanese branch of the international neurovegetative research, on the 8th July 1962.

Nervous influences upon the heart due to overdistension of the urinary bladder: the relation of its mechanism to vago-vagal reflex.

Studies on electrophysiological properties of vago-vagal reflex.

Although it has been known that dysfunction of the autonomic nerve may be held responsible for causing a variety of disease states, it was by J. Reilly in 1934 that a convincing experimental evidence was presented for the fact that irritation of the autonomic nerve gives rise to an unspecific type of reaction within the organism with widespread pathological processes. Ever since, a large number of experimental studies have demonstrated that irritation of the auto nomic nerve induces lesions not only in the organs which are under direct in nervation of the nerve but also in those organs which are not directly related to the nerve. This phenomenon has been termed Reilly's phenomenon (Syndrome d'irritation neuro-vegetative) (1), and has been the subject of a large number of clinical as well as experimental studies(2). The exact mechanism of this pheno menon, however, remains to be elucidated. The lesions induced as the result of autonomic nerve irritation include petechial hemorrhage in the pancreas, adrenals, myocardium, small hemorrhage and infarction in the lungs, scattered small hemorrhages in the gastric mucosa and hematuria. Those lesions are char acterized histologically by marked dilatation and stagnation of the capillaries and petechial hemorrhages. This factis in support of the view that Reilly's phenome non is mediated by disturbance of the function of the vascular system. Yamaguchi et al(3) has previously expressed the view that both autonomic nervous and endocrine systems are participating in the reaction to autonomic nerve irritation. The present study has been undertaken to investigate the be havior of the peripheral vascular bed in response to autonomic nerve irritation in order to obtain a clue for elucidating the complex relationship between those two systems.

Studies on the microcirculation under the influence of the autonomic nerve irritation.

The autonomic irritation from the digestive organs and the urinary tract influences upon the cardiac function. Using the electrophysiological technique, this mechanism was revealed.

1.

The authors presented two patients with arrhythmia, the one suffering from dysuria and the other suffering from cholelithiasis. These arrhythmias appeared with overdistension of the urinary bladder and operative procedure, and disappeared promptly by urination and cholecystectomy.




2.

Experimental overdistension of the urinary bladder in dogs, rabbits and guinea pigs resulted in transitory fall of blood pressure, pictures of coronary insufficiency in EKG and/or appearance of arrhythmias. These changes disappeared by relieving the bladder of overdistension.




3.

In guinea pigs it was shown that the EKG changes produced by overdistension of the urinary bladder were erased by transection of the spinal cord between the lumbo-sacral segment.




4.

Electrophysiological study showed that the nervous transmission from the bladder wall to the heart was related to, vago-vagal reflex.




5.

It was known that the irritation of the gallbladder and gastro-enterical tract sometimes produced the myocardial changes.

Yoichi Yamaguchi

Papers

Experimental studies on the pathological changes in the several organs due to irritation of the autonomic nervous system

Nervous influences upon the heart due to overdistension of the urinary bladder: the relation of its mechanism to vago-vagal reflex.

Studies on electrophysiological properties of vago-vagal reflex.

Studies on the microcirculation under the influence of the autonomic nerve irritation.

Action of autonomic nervous reflex arising from visceral organs upon the heart