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Over a period of 6 years, 8 patients underwent surgical treatment at our hospital for congenital coronary artery fistula (CAF). The ages of the patients ranged from 4 months to 50 years (mean 22.7 years). Continuous heart murmurs could be heard in all patients, except one. The diagnosis was made by retrograde aortography and/or selective coronary arteriography. Only one patients had associated cardiac disease. All the drainage sites of the CAF were on the right side of the heart (right atrium, right ventricle, pulmonary artery). Two patients had both right and left CAFs. Symptoms due to "coronary steal" by a coronary artery fistula were demonstrated by a nuclear medicine study in one of our patients. Four patients were operated on with the aid of cardiopulmonary bypass. The other 4 patients were treated with suture ligation directly. There was no surgical mortality or morbidity, and the longterm results have been good. Since surgical correction is safe and effective, it would appear desirable for all patients with CAF be operated on. However, surgical intervention is controversial in asymptomatic patients.

The influence of catecholamines on growth hormone (GH) release in female goldfish was investigated by monitoring serum GH levels following injections of drugs known to alter catecholamine synthesis and neural activities. Intraperitoneal (i.p.) injection of 6-hydroxydopamine, a catecholaminergic neurotoxin, or alpha-methyl-p-tyrosine, a catecholamine synthesis inhibitor, decreased serum GH levels. Intraperitoneal injection of L-beta-dihydroxyphenylalanine (L-dopa) increased serum GH concentrations in a dose-dependent manner. The L-dopa-induced increase in serum GH was potentiated by i.p. injection of carbidopa, which would increase the availability of L-dopa to brain tissues by blocking the peripheral conversion of L-dopa to dopamine (DA). These results suggest that L-dopa or one of its catecholamine metabolites acts centrally to increase GH release. Intraventricular (i.v.t.) injection of DA and i.p. injection of apomorphine, a DA agonist that crosses the blood-brain barrier, increased serum GH. Intraperitoneal injection of DA did not alter circulating GH levels in normal fish or fish bearing preoptic lesions that abolish an inhibitory hypothalamic influence on GH release; however, DA increased serum GH in fish which had their blood-brain barrier destroyed by sham operation procedures. These results indicate that DA acts centrally to stimulate GH secretion, possibly by inhibiting the release and/or synthesis of GH release-inhibitory factor. Serum GH concentrations were decreased in a dose-dependent manner by i.p. injection of norepinephrine (NE), whereas i.v.t. injection of NE did not alter serum GH levels. These results indicate that NE acts outside of the blood-brain barrier to decrease serum GH levels in the goldfish, possibly by directly influencing pituitary GH cells.(ABSTRACT TRUNCATED AT 250 WORDS)

The roles of calcium ions and voltage-sensitive calcium channels in gonadotropin-releasing hormone (GnRH)-stimulated luteinizing hormone (LH) release were investigated in rat anterior pituitary cells. The calcium ionophores A23187 and ionomycin stimulated LH release from cultured pituitary cells, in which ionomycin (5 X 10(-5) M) was as effective as a maximal concentration of GnRH (10(-8) M). In addition, a concentration of the calcium channel agonist methyl 1,4-dihydro-2,6-dimethyl-3-nitro-4-(2-trifluoromethylphenyl)-pyridine- 5-carboxylate (BK 8644) (10(-8) M), which did not alter basal LH release, potentiated the ability of submaximal (10(-10) and 10(-9) M) doses of GnRH to increase LH secretion. Furthermore, concentrations of the calcium channel antagonist nitrendipine (10(-8)-10(-5) M) that did not alter basal LH release, inhibited GnRH-stimulated LH secretion by 30-40%. Nitrendipine (10(-8) M) also blocked the potentiation of GnRH-induced LH secretion by BK 8644. During column perifusion of pituitary cells, 10(-8) M nitrendipine reduced the LH response to a 2-min pulse of 10(-8) M GnRH by about 40%. In Quin-2-loaded pituitary cells, supramaximal doses (10(-6) M) of a potent GnRH agonist rapidly elevated cytoplasmic Ca2+ by 50-100 nM. Concomitant treatment with nitrendipine decreased the GnRH agonist-induced Ca2+ signal by 40-60%. These results indicate that increases in intracellular Ca2+ via voltage-sensitive calcium channels partially reproduce GnRH action, and also that GnRH causes activation of such channels. However, the increase in cytoplasmic Ca2+ concentration during GnRH action must originate in part from mobilization of internal Ca2+ stores, and its relatively small magnitude may be consistent with the concomitant activation of protein kinase C as an intermediate step in GnRH action.

The role of protein kinase C in luteinizing hormone (LH) release was analyzed in studies on the actions of phorbol esters and gonadotropin-releasing hormone (GnRH) in normal and protein kinase C (Ca2+/phospholipid-dependent enzyme)-depleted pituitary cell cultures. LH secretory responses of normal pituitary cells to GnRH were reduced but not abolished in Ca2+-deficient medium, consistent with the existence of extracellular Ca2+-dependent and -independent components of GnRH action. Both of these components could be elicited by treatment with 12-O-tetradecanoylphorbol 13-acetate (TPA). The LH secretory responses to TPA and GnRH were additive only at low doses and converged to a common maximum at high concentrations of the agonists in the presence or absence of extracellular Ca2+. The release of stored LH by GnRH and TPA was accompanied by secretion of newly synthesized LH from 2 to 5 h during stimulation by either of the agonists. LH synthesis was increased in a progressive and dose-dependent manner by GnRH and TPA, and the ratio between newly synthesized and released hormone was near 1:2. TPA caused rapid and complete translocation of cytosolic protein kinase C to the particulate fraction of pituitary cells, followed by a progressive decrease in total enzyme content to approximately 10% after 6 h. Partial recovery of the cytosolic enzyme (to 20%) occurred after washing and reincubation for 15 h. Such kinase C-depleted cells showed prominent, dose-dependent reductions in the actions of GnRH and TPA on LH release and synthesis in both normal and Ca2+-deficient media. These observations support the hypothesis that protein kinase C participates in LH biosynthesis and secretion in pituitary gonadotrophs and is involved in the actions of GnRH upon these processes.

The role of protein kinase C in luteinizing hormone (LH) release was analyzed in studies on the actions of gonadotropin releasing hormone (GnRH) and phorbol esters in cultured pituitary cells. During incubation in normal medium, GnRH stimulated LH release with an ED50 of 0.35 nM. Incubation in Ca2+-deficient medium (Ca2+-free, 10 microM) substantially decreased but did not abolish the LH responses to GnRH. The extracellular Ca2+-dependent component of GnRH action could be mimicked by high K+ concentrations, consistent with the presence of voltage-sensitive calcium channels (VSCC) in pituitary gonadotrophs. Ca2+ channel agonist (Bay K 8644) and antagonist (nifedipine) analogs, respectively, enhanced or partially inhibited LH responses to GnRH and also to K+, the latter confirming the participation of two types of VSCC (dihydropyridine-sensitive and -insensitive) in K+-induced secretion. Phorbol esters, including 12-O-tetradecanoylphorbol-13-acetate (TPA), 4 beta-phorbol-12,13-dibenzoate, and 4 beta-phorbol-12,13-diacetate, stimulated LH release with ED50s of 5, 10, and 1000 nM, respectively, and with about 70% of the efficacy of GnRH. Phorbol ester-stimulated LH secretion was decreased but not abolished by progressive reduction of [Ca2+]e in the incubation medium, and the residual LH response was identical with that elicited by GnRH in Ca2+-deficient medium. TPA increased [Ca2+]i to a peak after 20 s in normal medium but not in the absence of extracellular Ca2+, indicating that protein kinase C (Ca2+/phospholipid-dependent enzyme) promotes calcium entry but can also mediate secretory responses without changes in calcium influx and [Ca2+]i. The extracellular Ca2+-dependent action of TPA on LH release was blocked by Co2+. However, nifedipine did not alter TPA action on [Ca2+]i and LH release. These observations indicate that protein kinase C can participate in GnRH-induced LH release that is independent of Ca2+ entry, but also promotes the influx of extracellular Ca2+ through dihydropyridine-insensitive Ca2+-channels.

The hypothalamic neuropeptide gonadotropin-releasing hormone (GnRH) stimulates luteinizing hormone secretion via receptor-mediated activation of phosphoinositide hydrolysis to yield inositol phosphates and diacylglycerol. Application of anion-exchange high-performance liquid chromatography together with absorbance and radiochemical flow detection has enabled both the characterization and quantitative estimation of pituitary cell inositol phosphates and phosphoinositides. In cultured pituitary cells, GnRH caused a rapid and progressive rise in the formation of inositol 1,4,5-trisphosphate and of higher polyphosphoinositols corresponding to inositol tetrakisphosphate, pentakisphosphate, and hexakisphosphate. The inositol 1,4,5-trisphosphate formed during GnRH action was dephosphorylated predominantly via inositol 4-monophosphate rather than the expected metabolite, inositol 1-monophosphate. The catabolism of inositol 4-monophosphate, like that of inositol 1-monophosphate, was inhibited by lithium. For these reasons and because it was the major metabolite of [3H] inositol 1,4,5-trisphosphate in permeabilized gonadotrophs, inositol 4-monophosphate appears to represent a specific marker for ligand-stimulated inositol polyphosphate formation and metabolism. The marked and sustained elevations of inositol 4-monophosphate and inositol 1,4-bisphosphate in GnRH-stimulated gonadotrophs indicate that polyphosphoinositides rather than phosphatidylinositol are the preferred substrates of phospholipase C during GnRH action.

Young male Sprague-Dawley rats were injected intraperitoneally with a single dose of aflatoxin B1 (AFB1, 3 mg/kg). At 3, 6, 12, and 24 hours and 1, 2, and 5 weeks, the rats were killed and liver samples were taken for examination of sequential ultrastructural changes and localization of acid phosphatase (AcPase), thiamine pyrophosphatase (TPPase) and glucose-6-phosphatase (G6Pase) activity. At 3-6 hrs of AFB1 treatment, the nucleoli became compacted and the network forms of nucleolonema disappeared. Parallel arrays of rough ER encountered in normal liver cells became deranged. Smooth ER increased to form groups of SER anastomosis or vesicles near the golgi area. At 12-24 hours, disruptions of nucleoli, ER systems, and polysomes became more evident. Parallel arrays of ER membranes, forming whorls in the cytoplasm as well as in the cytoplasmic patches (CP), were G6Pase-positive, although the CP were AcPase-negative. The TPPase reaction in bile canaliculi was frequently diminished, but was present in some measure in the Golgi saccules. By 1-2 weeks, most of the injured cells had recovered gradually. The CP disappeared and parallel arrays of RER were observed again in most parenchymal cells. At 5 weeks, the appearance of the nucleoli was normal, as was that of the other organelles. We concluded that the hepatic parenchymal cells had serious lesions at 12 and 24 hours of AFB1 treatment and then recovered nonsynchronously. The response, resistance, and ability to recover from the toxicity of AFB1 varied among the parenchymal cells. The three marker enzymes persisted throughout all regimens of AFB1 treatment.

The standard lead precipitation method was used for ultracytochemical localization of glucose-6-phosphatase (G-6-Pase) in the in vivo and in vitro forms of the Chang rat hepatoma and in the normal adult rat liver. Reaction product was visualized as very fine particulate within the cisternae of the nuclear envelope and endoplasmic reticulum. Cytochemically, the amount of the G-6-Pase reaction product in both forms of the tumor cells was obviously less than that in the normal hepatocytes. Apparently, the enzyme was not completely deleted from the hepatoma cells. The results supported some biochemical data of certain other hepatomas. The successful ultracytochemical localization of G-6-Pase in cultured hepatoma cells has not been reported previously.