We previously examined the effect of alcohol on muscle energy metabolism in chronic alcoholics by using 31P-magnetic resonance spectroscopy. Measurements of intracellular pH and PCr index [PCr/(PCr + Pi)] during resting, hand grasping, and recovery in the left flexor digitorum superficialis muscle of alcoholics with neurological signs showed a marked decrease and delayed recovery of pH, but rapid recovery of PCr index indicating that the muscle produces lactate during and after exercise to maintain the ATP level. To clarify the reason for this preference for anaerobic metabolism, we conducted simultaneous measurements of the muscle blood supply during and after exercise by using the near-infrared light method and energy metabolism by using 31P-magnetic resonance spectroscopy. In alcoholics with neurological signs, we observed a significant increase of oxyhemoglobin after exercise with a slight increase of total hemoglobin. In healthy volunteers and chronic alcoholics without neurological signs, such an overshoot of oxyhemoglobin was not observed. We conclude that chronic alcoholics with neurological signs have an abnormality of aerobic metabolism owing to muscle mitochondrial dysfunction.

We investigated the effect of alcohol on muscle energy metabolism by using 31P magnetic resonance spectroscopy in 12 chronic alcoholics [6 with neurological signs and symptoms (such as cerebellar ataxia or diplopia) and 6 without neurological signs or symptoms], compared with five healthy subjects who also received acute alcohol loading. Intracellular pH and phosphocreatine (PCr) index [PCr/ (PCr + Pi)] were measured during rest, exercise, and recovery in the left flexor digitorum superficialis muscle. In healthy subjects, acute alcohol loading did not influence the changes of muscle pH and PCr index. Alcoholics with neurological signs showed marked decreases in muscle intracellular pH and PCr index during exercise and a marked delay of pH recovery after exercise. There was no delay of PCr index recovery. Alcoholics without neurological signs showed slight decreases in intracellular pH and PCr index, but rapid recovery of both intracellular pH and PCr index was observed. Marked decrease and delayed recovery in pH, but rapid recovery of PCr index, indicate that the muscle of patients with neurological signs produced lactate during and after exercise to maintain the ATP level, which implies that anaerobic metabolism is favored over aerobic metabolism in these patients.

Nipradilol is a new type of (3-blocker which possesses nitroglycerin-like vasodilating action in addition to (3-blocking action. Weinvestigated the efficacy and safety of nipradilol for treating tremor in 20 patients with essential tremor (ET group) and 20 patients with Parkinson's disease (PD group). All patients received nipradilol (6 mg per day) for more than 8 weeks. Improvement of tremor appeared within 2 or 4 weeks after the start of nipradilol therapy, and the efficacy rate, defined as "moderately effective" or over, was 42.5% in all 40 patients, while that defined as "slightly effective" or over was 87.5%. The efficacy rate tended to be higher in the ET group compared with the PD group. Mean blood pressure was significantly decreased from the 4th week after the start of treatment and heart rate was significantly reduced from the 2nd week of treatment. Laboratory examination showedno significant changes. (Internal Medicine 35: 861-865, 1996)

We previously examined the effect of alcohol on muscle energy metabolism in chronic alcoholics by using 31 P-magnetic resonance spectroscopy. Measurements of intracellular pH and PCr index [PCr/ (PCr + Pi)] during resting, hand grasping, and recovery in the left flexor digitorum superficialis muscle of alcoholics with neurological signs showed a marked decrease and delayed recovery of pH, but rapid recovery of PCr index indicating that the muscle produces lactate during and after exercise to maintain the ATP level. To clarify the reason for this preference for anaerobic metabolism, we conducted simultaneous measurements of the muscle blood supply during and after exercise by using the near-infrared light method and energy metabolism by using 31 P-magnetic resonance spectroscopy. In alcoholics with neurological signs, we observed a significant increase of oxyhemoglobin after exercise with a slight increase of total hemoglobin. In healthy volunteers and chronic alcoholics without neurological signs, such an overshoot of oxyhemoglobin was not observed. We conclude that chronic alcoholics with neurological signs have an abnormality of aerobic metabolism owing to muscle mitochondrial dysfunction.

A case of neuroendocrine lung tumor located beneath the pleura in a 71 year old woman is reported. At autopsy, the tumor was found to have metastasized to the bones and liver without involving the hilar lymph nodes. Histological‐ly, the tumor cells at the primary site and in the liver metastasis exhibited a carcinoid‐like organoid structure, whereas pleomorphic giant cells were noted in the bone metastasis. The argyrophilic tumor cells were immuno‐reactive for neuron specific enolase, chromogranin A, serotonin, calcitonin, calcitonin gene‐related peptide, gas‐trin‐releasing peptide, neuropeptide Y, gastrin, pancreatic polypeptide, glicentin, the alpha subunit of human cho‐rionic gonadotropin, keratin, epithelial membrane antigen, Leu M1 and carcinoembryonic antigen. Electron microscopy revealed abundant neurosecretory granules in the cytoplasm. This was considered to be a rare case of neuroendocrine lung tumor showing carcinoid like histology at the primary site and large‐cell transformation in bone metastasis.