Cell surface [3H]CGP 12177 binding sites in 10-wk streptozocin-diabetic rats decreased by 41% (P less than 0.01) compared with that in the control rats. In contrast, there was no difference in the total cell receptor concentration between the control and the diabetic rats, which was measured by hydrophobic antagonist [125I]-iodocyanopindolol binding. Forty-eight-hour in vivo insulin treatment significantly (P less than 0.05) increased cell surface beta-adrenergic receptor concentration by 37% above that in diabetic rats without any change in total receptor concentration in the cells. However in vitro treatment of 8 nM insulin, 33 mM glucose, or 10 mM 3-hydroxybutyrate for 2 h showed no effect on [3H]CGP 12177 binding. In contrast, 10 microM isoproterenol-dependent decrease and the recovery of cell surface receptors after the removal of the agonist were significantly (P less than 0.01) impaired in diabetic rats compared with those of control rats. These results indicate that only cell surface beta-adrenergic receptors decrease in diabetic rats, which may be associated with abnormalities in the receptor distribution. The decrease in cell surface receptor number closely associates with the diabetic state and is reversed by the short-term insulin treatment.

Endotoxin contamination in modified hemoglobin can result in side effects. Accurate measurement and effective elimination of endotoxin are important in producing safe hemoglobin preparation. A new turbidometric endotoxin assay (Toxinometer) was studied, in which absorbance of wavelength was applied at 660 nm. This method is not affected by the presence of hemoglobin in solution. This way, toxinometer can accurately measure endotoxin concentration in hemoglobin solution. For the elimination of endotoxin, polymyxin-B immobilized fiber (PMX-F) was studied in-vitro and compared with commercial materials. The PMX-F was found to be a convenient and less expensive approach.

An infant born in the 34th week of gestation weighing 5,355 g with a massive sacrococcygeal (SC) tumor was delivered by elective cesarean section. An ultrasonographic examination showed solid and cystic components in the tumor. Resection was successfully undertaken with insertion of a Nélaton catheter into the rectum to avoid unnecessary impairment of the viscera. The tumor weighed 2,380 g, measured 25 x 14 x 11 cm, and was clinicopathologically diagnosed to be a SC teratoma. This experience and other publications show that several considerations including control of hemorrhage and coagulopathies, visceral protection, and avoidance of wound infection are necessary to facilitate the surgical management of massive SC tumors. Several suggestions are made concerning the pre- and intraoperative management of this rare tumor.

Guest Editor's Introduction: Endotoxins, which consist of lipopolysaccharides (LPS), are known to be a pathogenic substance in patients with septic shock. Since Nolan reported endotoxin adsorption by ion exchange resin and activated charcoal, the search for more effective adsorbents were continued and have lead to the development of polymyxin B immobilized fibers. Polymyxin B is a cationic antibiotic agent which interacts with acidic phospholipids and LPL by electrostatic force. This paper was the first report written in English regarding polymixin B immobilized fibers. The adsorbent is now known as Toraymyxin PMX‐20R and manufactured by Toray Co. This paper was published in Therapeutic Apheresis: A Critical Look, Y. Nosé, P.S. Malchesky, and J,W. Smith eds., ISAO Press, page 167–170 (1984). A new method of preparing polymyxin B fixed to insoluble fiber (PMX‐F) was developed. PMX‐F (1 g) was detoxified with 0.5–4.8 mg of lipopolysaccharides (LPS) as endotoxin (ET) in a batch system. Fixed polymyxin B(PX) was found to be firmly attached to fiber even after washing with isotonic saline or endotoxin solution. Toxicological study of the mortality of mice after injection of PMX‐F‐treated ET indicated that 24% (5 of 21) of the treated group survived, whereas 100% (21 of 21) of the untreated group died. In ex vivo experiments, direct hemoperfusion (DHP) by PMX‐F was performed for ET‐injected canine. Only 12.5% (1 of 8) survived in the control group, but 83% (10 of 12) survived in the group receiving DHP with PMX‐F. Mortality in the treated group decreased remarkably. The results thus indicate the efficacy of PMX‐F in neutralizing ET.