Crystal structure of an H-2Kb-ovalbumin peptide complex reveals the interplay of primary and secondary anchor positions in the major histocompatibility complex binding groove

Sequence analysis of peptides naturally presented by major histocompatibility complex (MHC) class I molecules has revealed allele-specific motifs in which the peptide length and the residues observed at certain positions are restricted. Nevertheless, peptides containing the standard motif often fail to bind with high affinity or form physiologically stable complexes. Here we present the crystal structure of a well-characterized antigenic peptide from ovalbumin [OVA-8, ovalbumin-(257-264), SIINFEKL] in complex with the murine MHC class I H-2Kb molecule at 2.5-A resolution. Hydrophobic peptide residues Ile-P2 and Phe-P5 are packed closely together into binding pockets B and C, suggesting that the interplay of peptide anchor (P5) and secondary anchor (P2) residues can couple the preferred sequences at these positions. Comparison with the crystal structures of H-2Kb in complex with peptides VSV-8 (RGYVYQGL) and SEV-9 (FAPGNYPAL), where a Tyr residue is used as the C pocket anchor, reveals that the conserved water molecule that binds into the B pocket and mediates hydrogen bonding from the buried anchor hydroxyl group could not be likewise positioned if the P2 side chain were of significant size. Based on this structural evidence, H-2Kb has at least two submotifs: one with Tyr at P5 (or P6 for nonamer peptides) and a small residue at P2 (i.e., Ala or Gly) and another with Phe at P5 and a medium-sized hydrophobic residue at P2 (i.e., Ile). Deciphering of these secondary submotifs from both crystallographic and immunological studies of MHC peptide binding should increase the accuracy of T-cell epitope prediction.

Activity of pallidal neurons in the monkey during dyskinesia induced by injection of bicuculline in the external pallidum

The present study was undertaken to determine whether dyskinesia, resulting from injection of the GABA antagonist bicuculline into the external globus pallidus of intact monkeys, is induced by hyperactivity of local external pallidal neurons and ensuing hypoactivity of neurons in the internal globus pallidus, at the output of the basal ganglia. Accordingly, 86% of responding external pallidal neurons increased and 56% of internal pallidal neurons decreased their activity, either exclusively or within biphasic responses. Whereas 29% of external pallidal neurons decreased and as much as 85% of internal pallidal neurons increased their activity. The latter unpredicted responses may be explained by diffusion of bicuculline from the external to the internal pallidum and by lateral monosynaptic inhibition within the external and its mirror image in the internal pallidum. With respect to individual injection sites, the hypoactive neurons in the internal pallidum tended to be grouped together and surrounded by hyperactive or unresponsive neurons. The changes occurred before and persisted during dyskinesia, suggesting that they were required to induce and maintain the dyskinesia. There were also changes in firing patterns, comprising long periods of silence, especially in external pallidal neurons close to the injection site. The periods of silence did not appear to result from depolarization block but rather from activation of receptors of inhibitory neurotransmission other than type A GABA. Dyskinesia therefore does not appear to result exclusively from a simple imbalance of activity between the pallidal segments, with hyperactivity in the external and hypoactivity in the internal segment, but also from imbalances within each pallidal segment, possibly with a center-surround organization.

Histological and immunohistochemical study of idiopathic epiretinal membrane

We used electron microscopy and light-microscopic immunohistochemistry of cellular and extracellular markers to characterize the cellular and extracellular components of 15 surgically resected idiopathic epiretinal membranes (IEMs). Ten specimens from the eyes with posterior vitreous detachment (PVD) consisted of inner limiting membrane, collagen layer and a flattened cell layer. Six out of the 10 specimens were also examined immunohistochemically, and fibronectin and type I, II, III and IV collagens were identified in a characteristic lamellar construct in the IEMs. On the other hand, 5 specimens obtained from the eyes without PVD consisted mainly of a thick layer of collagen fibrils with or without a flattened cell layer. Two of the 5 specimens were also examined immunohistochemically, and the collagen fibrils in the specimens were identified as type II collagen. Glial cells (glial fibrillary acidic protein-immunoreactive cells) were also identified in 3 specimens. These results indicate that there are some variations in the IEMs.

[Involvement of substance P in gastric mucosal lesions of patients with rheumatoid arthritis]

We investigated the relation between gastric mucosal lesions and substance P (SP) in 64 patients with rheumatoid arthritis (RA) taking nonsteroidal antiinflammatory drugs (NSAIDs). In these patients, the incidence of gastric mucosal lesions was as high as 53.1%. Serum SP levels were significantly higher in patients with gastric mucosal lesions than in those without gastric lesions. Erythrocyte sedimentation rate, serum C-reactive protein and rheumatoid factor (RF) levels were also higher in patients with gastric mucosal lesions. A positive correlation between serum SP and RF levels was found in patients with RA. Experimental gastric mucosal lesions induced by an oral administration of indomethacin in rats were significantly enhanced by an additional intraperitoneal injection of SP. From these observations, it is suggested that, in addition to the effect of NSAIDs, SP elevation in blood has a role in the development of gastric mucosal lesion in patients with RA.

Sensitive assay for detection of hepatocellular carcinoma associated gene transcription (alpha-fetoprotein mRNA) in blood

The sensitivity of RT-PCR and nested RT-PCR for detection of circulating hepatocellular carcinoma was assessed by demonstrating the tumor cell-associated gene transcription, alpha-fetoprotein mRNA, in the nuclear cells of peripheral blood. When HepG2 cells were mixed in blood, 100-1000 tumor cells/5ml of blood could be detected by RT-PCR, in contrast to 1-10 tumor cells/5ml of blood by nested RT-PCR. In addition, 2 x 10(4) copies of AFP mRNA were found in one HepG2 cell when analyzed by the quantitative nested RT-PCR assay. Thus, the nested RT-PCR assay could provide a useful tool for detecting a tiny amount of circulating tumor cells in patients with hepatocellular carcinoma presenting extra-hepatic metastasis.

Usefulness of a prototype intravascular ultrasound imaging in evaluation of aortic dissection and comparison with angiographic study, transesophageal echocardiography, computed tomography, and magnetic resonance imaging

The aim of this study was to evaluate the accuracy of information obtained with a prototype intravascular ultrasound (IVUS) system in chronic aortic dissection by comparing results with angiography, transesophageal echocardiography (TEE), computed tomography, or magnetic resonance imaging. We assigned 15 patients to IVUS imaging after they underwent angiography. The detection rate of the intimal flap was 100% in all segments of the aorta, and the detection rate of the intimal tear was 0%, 50%, 50%, and 77.8% in the ascending, arch, descending, and abdominal aorta, respectively. IVUS demonstrated 100% of the celiac and renal arteries, and 80% of the superior mesenteric arteries as well as their relation to dissection. It clarified the origin of 12 of 60 main abdominal branches (20%) which were not clear on the angiogram. It also determined the distal extent of the dissection in all cases. With regard to the size of the vessel, there was a good correlation between IVUS and computed tomographic values (r = 0.98, p < 0.01). No complications occurred in any patient. IVUS accurately demonstrated thrombus or spontaneous echo contrast in the false lumen that was confirmed with computed tomography or TEE, or both. It was especially useful in evaluating the abdominal aorta with regard to determining the size of the vessel, the extent of dissection, the relation of the branches to the false lumen, and the detection of intimal tears--important information for follow-up of patients and for planning surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Prenatally diagnosed female prune belly syndrome associated with tetralogy of Fallot

Female prune belly syndrome and tetralogy of Fallot were diagnosed in obstetric ultrasound screening at 13 and 28 weeks of gestation, respectively. The baby was born at 38 weeks showing abdominal distension, hypoplasia of abdominal muscles, vaginal atresia, imperforate anus and clubfeet. Radiologic and ultrasound examinations confirmed our prenatal diagnosis and revealed other abnormalities of patent ductus arteriosus, major aortopulmonary collateral arteries, bilateral vesicoureteral reflux, rectourethral fistula and hypoplasia of the right kidney. Urination has been smooth, but cystitis was observed repeatedly once a month. The infant was discharged in good condition and has been followed in the outpatient clinic.

[Usefulness of intracardiac echocardiography for guidance of transseptal puncture procedure]

The clinical usefulness of intracardiac echocardiography (ICE) for the guidance of transseptal puncture procedure during percutaneous left heart bypass support (PLHBS) and percutaneous transvenous mitral commissurotomy (PTMC) was investigated to replace intraoperative transesophageal echocardiography monitoring which requires mild sedation and causes patient discomfort. The ICE procedure was assessed in 3 patients with PLHBS and 18 with PTMC using a 10 MHz rotating 8 French probe system especially developed for the purpose. Transseptal puncture procedure was observed by intraoperative ICE monitoring in the right atrium. The ICE images showed the transseptal puncture (Brokenbrough) needle as a point casting an acoustic shadow. By moving the ICE probe up and down, the excursion of the needle and its approach to the septal wall could be clearly observed. If the puncture needle is forced into the intra-atrial septum, the septal wall was clearly observed to protrude into the left atrium (tent-formation). In a tent-formation the puncture site could be determined by ICE alone. Intracardiac echocardiography guidance was useful and may improve the safety and reliability of the transseptal puncture procedure in PLHBS and PTMC.

Eye movements in monkeys with local dopamine depletion in the caudate nucleus. I. Deficits in spontaneous saccades

The basal ganglia contribute to the suppression and initiation of saccadic eye movements through the inhibitory connection from the substantia nigra pars reticulata (SNr) to the superior colliculus. This mechanism consists of serial and parallel connections, which are mostly inhibitory and GABAergic. Dopamine is known to exert powerful modulatory effects on the basal ganglia function, but its nature and mechanism are still unclear, especially in relation to voluntary behavior. The purpose of this series of investigation was to study the role of dopamine in the control of saccadic eye movements. We examined, in the monkey, whether and how the deficiency of the nigrostriatal dopaminergic innervation affects saccadic eye movements. The present article is focused on spontaneous saccades that the monkey made with no incentive to obtain reward; the next paper will describe task-specific saccades. Using an osmotic minipump we infused 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) unilaterally into the head-body junction of the caudate nucleus of monkeys where presaccadic neurons were clustered. Tyrosine hydroxylase activity, visualized using an immunohistochemical method, decreased locally around the injection site with some effects extending into the ipsilateral putamen and locally in the ipsilateral substantia nigra. Changes of eye movements started to appear 3-5 d after starting the infusion. Spontaneous saccades became less frequent. The area scanned by the saccades became narrower and shifted to the hemifield ipsilateral to the infusion site. The saccade amplitudes and peak velocities decreased; durations were prolonged. These effects were more prominent for saccades directed toward the side contralateral to the infusion site. These monkeys showed no obvious skeletomotor symptoms. These results suggest that the local deprivation of the dopaminergic innervation in the caudate nucleus facilitates neuronal activity of the SNr leading to suppression of saccadic eye movements.

Eye movements in monkeys with local dopamine depletion in the caudate nucleus. II. Deficits in voluntary saccades

Unilateral infusion of MPTP into the monkey caudate nucleus produced deficits in task-specific saccades, in addition to the deficits in spontaneous eye movements (preceding article). We trained three monkeys to perform two kinds of saccade tasks: (1) saccade task for eliciting visually guided saccades and (2) delayed saccade task for eliciting memory-guided saccades. After the MPTP infusion, dopaminergic function, estimated by tyrosine hydroxylase (TH) immunoreactivity, was shown to be decreased locally around the infusion site at the head-body junction of the caudate. We found that the deficits were prominent in the saccades directed to the side contralateral to the infusion (contralateral saccades). Memory-guided saccades were sometimes misdirected to the ipsilateral side even when the cue stimulus was presented on the contralateral side. Among the parameters of saccades, a selective change was found in the saccade latency: the latency was prolonged consistently in contralateral memory-guided saccades. The amplitude and velocity of saccades decreased in contralateral saccades, either memory guided or visually guided. The duration of saccades tended to increase in visually-guided saccades and memory-guided saccades, in both directions. Only one monkey, in which the decrease in TH activity included a large part of the putamen and the head of the caudate, showed prolongation of manual reaction time for lever release.

Stepped care medical treatment for cirrhotic ascites: analysis of factors influencing the response to treatment

Thirty-two patients with liver cirrhosis and ascites were treated by stepped care diuretic treatment as follows: step 1, placed on a 35 mEq sodium diet; step 2, given 400 mg/day of potassium canrenoate in addition to step 1 treatment; step 3, given 40-80 mg/day of furosemide in addition to step 2 treatment. Eleven out of 32 patients (34.4%, group 1) and 12 of 21 patients (57.1%, group 2) lost their ascites at step 1 and step 2, respectively. The remaining nine patients (group 3) required step 3 treatment. Basal urinary sodium excretion and creatinine clearance were significantly lower and beta 2-microglobulin was significantly higher in group 3 than those in groups 1 and 2. Elevation of basal plasma renin activity and norepinephrine was evident only in group 3. In group 1, urinary sodium excretion decreased after the treatment. In group 2, plasma alpha-atrial natriuretic polypeptide was lowered and plasma renin activity and norepinephrine were elevated after the treatment. These results suggest that basal renal function and plasma renin activity and norepinephrine levels are useful indices to predict the effect of ascites treatment and that responders to sodium restriction or potassium canrenoate may be in the state of vascular overflow, while non-responders to potassium canrenoate may be in the state of vascular underfilling. In summary, this stepped care treatment is safe without any side effects, although the diuretics themselves may lead to relative vascular underfilling.

Role of polymorphonuclear leukocytes in galactosamine hepatitis: mechanism of adherence to hepatic endothelial cells

To investigate the role of polymorphonuclear leukocytes in galactosamine-induced hepatic injury, we injected rats intraperitoneally with antiserum against rat polymorphonuclear leukocytes to deplete circulating neutrophils, then administered galactosamine plus lipopolysaccharide. Polymorphonuclear leukocytes in the hepatic sinusoids were increased after administration of galactosamine plus lipopolysaccharide, whereas pretreatment with the antiserum decreased the number of circulating leukocytes and reduced the mortality and the severity of hepatic injury. Serum collected 1 hr after galactosamine/lipopolysaccharide treatment enhanced in vitro polymorphonuclear leukocyte adherence to hepatic endothelial cells and induced leukocyte superoxide production. Intercellular adhesion molecule-1 expression on hepatic endothelial cells was also enhanced after stimulation with the serum. Polymorphonuclear leukocyte adhesion was partially inhibited by an antibody against tumor necrosis factor-alpha but not by superoxide dismutase. These results suggest that polymorphonuclear leukocytes play an important role in galactosamine-induced hepatic injury and that the accumulation and activation of leukocytes, as well as the enhanced expression of adhesion molecules on hepatic endothelial cells, can be induced by biologically active mediators such as tumor necrosis factor-alpha. In addition, prostaglandins E1 and E2 lessened the enhanced adherence of polymorphonuclear leukocytes and thus contributed to protection against hepatic injury.

[Local characteristic of allergic diseases: adult asthma in the central area of Tokyo]

In order to know the characteristic of urban asthma, were analyzed patient records in our clinic located in the central area of Tokyo. Eighty four adult patients who were living in walking distance with asthma started in this area, visited our clinic in October 1991. Among them 57 (68%) were atopic type. 13 (15%) mixed type, and 14 (17%) infectious type. Even among 25 patients with late onset asthma over 40 year of age, there were 8 atopic type and 5 mixed type, and 11 were positive against house dust by RAST and/or skin test. Atopic type seems to be unusually frequent in urban asthma. It reminds us of the fact that Japanese cedar pollinosis is more frequent in urban area than the mountain area with much more cedar trees. These might suggest important points to be studied, not only the adjuvant effect but also some accelerating effect for allergic diseases in the urban environment.

Detection of alpha-fetoprotein mRNA, an indicator of hematogenous spreading hepatocellular carcinoma, in the circulation: a possible predictor of metastatic hepatocellular carcinoma

We attempted to detect circulating hepatocellular carcinoma by demonstrating hepatocyte-associated mRNA in the nuclear cell component of peripheral blood using nested reverse transcription-polymerase chain reaction because of the extremely small number of tumor cells in the circulation. Albumin mRNA was demonstrated not only in the liver tissue (hepatocytes) and HepG2 cells but also in nuclear cells of the blood from normal healthy volunteers (neutrophils and lymphocytes) by reverse transcription-polymerase chain reaction. In contrast, alpha-fetoprotein mRNA was demonstrated in the liver tissue, as well as in HepG2 cells, but not in peripheral blood of normal healthy volunteers, indicating the possibility of using alpha-fetoprotein mRNA for detection of benign and malignant hepatocytes among the population of neutrophils and lymphocytes. alpha-Fetoprotein mRNA in peripheral blood was detected in 17 of 33 cases of hepatocellular carcinoma (52%), 2 of 13 cases of cirrhosis (15%) and 2 of 17 cases of chronic hepatitis (12%). alpha-Fetoprotein mRNA was not demonstrated in 26 cases of normal healthy volunteers (0%). Among the patients with hepatocellular carcinoma, total volume of tumor tissue, maximum size of tumor and serum alpha-fetoprotein level were markedly increased in the patients with alpha-fetoprotein mRNA in blood. In addition, alpha-fetoprotein mRNA was detected in the blood of all 6 patients showing metastasis at extrahepatic organs (100%), in contrast to 11 of 27 cases without metastasis (41%). From these results, we conclude that the presence of alpha-fetoprotein mRNA in peripheral blood may be an indicator of circulating malignant or benign hepatocytes, which might predict hematogenous spreading metastasis of tumor cells in patients with hepatocellular carcinoma.

Plasma endotoxin concentration and endotoxin binding capacity of plasma acute phase proteins in cirrhotics with variceal bleeding: an analysis by new methods

Plasma endotoxin levels in 12 cirrhotics with bleeding from oesophageal varices and 50 cirrhotics without bleeding were measured by the chromogenic assay after the pretreatment of sample by perchloric acid (HClO4) and triethylamine. Endotoxin in cirrhotics with bleeding from varices was significantly higher than those without bleeding. In patients with bleeding, endotoxin increased for 3 days after the bleeding, first in the supernatant fraction and then in the precipitate fraction by HClO4 treatment. Peak plasma alpha 1-acid glycoprotein and haptoglobin were observed 3 days after the bleeding. Alpha 1-antitrypsin gradually increased for 14 days. Transferrin did not markedly change. The endotoxin-binding capacity of transferrin and alpha 1-acid glycoprotein increased immediately after bleeding and thereafter decreased, but that of alpha 1-antitrypsin tended to increase in the recovery period. In summary, the plasma endotoxin concentration and endotoxin-binding capacity of alpha 1-acid glycoprotein and transferrin were shown to have increased after bleeding from varices by this new method. There may be a close relationship between endotoxaemia and acute phase reaction in this situation.

High incidence of HAM/TSP-like symptoms in WKA rats after administration of human T-cell leukemia virus type 1-producing cells

We demonstrate a significantly high incidence of human T-cell leukemia virus type 1 (HTLV-1)-associated myelopathy (HAM)-or tropical spastic paraparesis (TSP)-like symptoms in WKA rats after injection with HTLV-1-producing MT-2 cells, while no symptoms were observed in F344 rats injected with MT-2 cells or in control WKA rats. Five of the eight (63%) WKA rats injected with MT-2 cells showed HAM/TSP-like paraparesis at 105 weeks of age, but none of seven MT-2-injected F344 rats or eight control WKA rats showed symptoms. This high incidence of HAM/TSP-like symptoms in WKA rats was statistically significant (P < 0.05). Six of the eight (75%) WKA rats injected with MT-2 cells showed HAM/TSP-like paraparesis at 108 weeks of age. HAM/TSP-like symptoms were also observed in one of the two WKA rats injected with HTLV-1-producing Ra-1 cells at 128 weeks of age. HTLV-1 provirus was detected in peripheral blood mononuclear cells in both WKA and F344 rats. The provirus was detected in the spinal cords of the HAM/TSP-like WKA rats that had severe neuropathological changes. WKA and F344 rats showed no significant difference in antibody response against HTLV-1 Gag antigen. However, the antibody response against the C-terminal half of gp46 HTLV-1 envelope protein was lower in WKA rats than in F344 rats. Pathological analysis of the HAM/TSP-like rats showed degeneration of the white matter of the spinal cord and peripheral nerves. These findings suggest that both the genetic background of the host and HTLV-1 infection are important in neuropathogenesis of HAM/TSP-like paraparesis in rats.

A neuropathological study of paraparetic rats injected with HTLV-I-producing T cells

In order to clarify the pathogenesis of HTLV-I-associated myelopathy or tropical spastic paraparesis (HAM/TSP), we injected HTLV-I-producing rabbit or human T cells intravenously into WKA and F344 rats. Infection was confirmed from increase in the anti-HTLV-I antibody titer and from the presence of HTLV-I proviral DNA. Only WKA rats developed hindlimb paraparesis 78-124 weeks after the injection. Neuropathological examination of 5 rats showed degeneration of the anterolateral and posterior funiculi as well as the peripheral nerves, and this degeneration was characterized by prominent vacuolation and macrophage infiltration. The myelopathy and neuropathy were grossly similar to those in human HAM/TSP. Although pathological changes of the spinal cord were very mild in 2 paretic rats, and similar lesions were found in the spinal cords and peripheral nerves of 2 control WKA rats, the myelopathy, radiculoneuropathy, or both in the paretic rats showed greater severity than in the controls. The contribution of the aging process to the lesions of the spinal cord and peripheral nerve is discussed. It appears possible that HTLV-I may accelerate the aging process and give rise to paraparesis. The precise role of HTLV-I in the pathogenesis of rat paraparesis remains to be elucidated taking the role of the aging process of the spinal cord and peripheral nerve into account.

[Detection of autoantibodies in sera from patients with rheumatoid arthritis]

Although Rheumatoid Arthritis (RA) is categorized in the systemic autoimmune diseases, specific autoantibodies in RA have been reported to be rare. We have investigated autoantibodies found in sera from patients with RA and examined their clinical significance. Immunoprecipitation techniques using 32P-labeled or 35S-labeled HeLa cell extracts and immunoblotting were utilized to detect autoantibodies in sera from 42 patients with RA and 58 patients with other connective tissue diseases as controls. Certain autoantibodies were detected in 33 of 42 patients (79%) with RA by any of the assay systems mentioned above. Anti-SSA/Ro, anti-SSB/La, anti-7-2RNP, and anti-Sm antibodies were found in 13 (29%), 3 (7%), 4 (10%), and 1 (2%) patients with RA, respectively. All 3 patients with anti-SSB/La and 9 with anti-SSA/Ro revealed Sjögren's syndrome besides RA. However, all 4 patients with anti-7-2RNP and one patient with anti-Sm showed no evidence of scleroderma nor SLE. Besides of these known autoantibodies, we have also detected 4 new antibodies which reacted with a 60kD protein in 15 (36%), 45kD in 10 (24%), 75kD in 8 (19%), 180kD in 4 patients (10%) with RA. These autoantibodies were not found in other connective tissue diseases except one of SLE for anti-60kD and one of dermatomyositis for anti-75kD, and therefore appeared to be specific for RA patients. Anti-45kD antibodies were associated with low prevalence of anti-nuclear antibodies, and anti-180kD antibodies were associated with lymphadenopathy and Sjögren's syndrome. Thus, it was demonstrated that patients with RA develop a variety of autoantibodies as well as those with other connective tissue diseases.

A case of primary gastric choriocarcinoma and a review of the Japanese literature

A 63-year old woman who had experienced melena for 2 weeks was admitted to Tokyo University Hospital. Gastric adenocarcinoma was diagnosed endoscopically and histologically, and a total gastrectomy was performed soon thereafter. Pathological examination of the resected stomach revealed choriocarcinoma of the stomach. Although chemotherapy was administered after surgery, she died 3 months after admission. Autopsy confirmed the diagnosis of primary gastric choriocarcinoma, a rare, but highly malignant tumor. It is characteristic; macroscopically it forms a necrotic mass with bleeding, and microscopically it often consists of adenocarcinoma and choriocarcinoma. Since its prognosis is extremely poor, we must take into account the possibility of primary gastric choriocarcinoma when a hemorrhagic gastric tumor with necrosis is found.

Modulation of KC/gro protein (interleukin-8 related protein in rodents) release from hepatocytes by biologically active mediators

Modulation of the release of KC/gro protein (a chemoattractant for neutrophils; IL-8 related protein in rodents) from isolated hepatocytes after stimulation with biologically active mediators was investigated. The release of KC/gro protein from hepatocytes of control rats was enhanced by stimulation with lipopolysaccharide, IL-1 beta or TNF-alpha in a dose-dependent manner, but was not enhanced by IL-6. In contrast, although spontaneous release of KC/gro protein from the hepatocytes of chronically ethanol-fed rats was markedly enhanced as compared with control rats, the relative increase by stimulation with lipopolysaccharide, IL-1 beta or TNF-alpha was significantly smaller than in controls. These findings suggest that the regulation of hepatocyte KC/gro protein production might be disturbed in chronically ethanol-fed rats.

Movement-related slow potentials during motor imagery and motor suppression in humans

Electro-encephalograms (EEGs) associated with motor imagery and motor suppression were recorded from motor-related frontal regions in humans. A negative potential was observed both during motor imagery and during NO-GO responses, as well as in movement trials. The negative potentials observed in the motor imagery trials had a similar pattern to those observed in the movement trials, although the potentials were different from those during NO-GO responses. The peak amplitude of the negative potential recorded at FCz was significantly larger than those recorded at F3, F4, C3 and C4 in the imagery task. The peak amplitude of the negative component in movement trials was larger than that in the imagery trials of all recording positions. By contrast, during the GO/NO-GO task, the peak amplitude during NO-GO responses was larger than that during the GO responses at every position. It appears, therefore, that motor imagery and motor suppression are associated with their own specific internal processes which are reflected by specific EEG patterns in motor-related frontal areas.

Movement-related potentials associated with motor inhibition as determined by use of a stop signal paradigm in humans

The motor inhibition process was examined in humans by monitoring reaction times, electromyograms, and movement-related potentials. Four subjects performed a simple visual Stop Signal Paradigm. The results were as follows. (1) The EEG waveform pattern was remarkably consistent among subjects. NO-GO-specific negative-positive potentials were observed under all experimental conditions. (2) The timing of the onset and the peak latency of the negative potential relative to the second stimulus, S2, were constant (about 200-210 ms and 250-260 ms for each) regardless of changes in the S2 delay. The time interval between the initial onset of the negative potential and its peak latency was constant (about 50 ms). (3) By contrast, the peak-to-peak time between the negative potential and the positive potential became smaller as the S2 delay was increased. It is suggested, therefore, that the motor inhibition process might consist of different sub-processes and that some part of the inhibition process might be of constant and specific duration.

[A case of idiopathic hypoparathyroidism associated with primary hypothyroidism and diabetes mellitus]

A 50-year-old man was admitted to our hospital for the evaluation of hypocalcemia and the treatment of diabetes mellitus. Seven months before admission, he sometimes felt thirst and polyuria, and 4 months before admission, he went to a doctor to check his blood glucose and was diagnosed as having diabetes mellitus which had suddenly developed. At that time he was treated with sulfonylurea, but his diabetic control was very poor. At the time of admission to our hospital, the patient's serum calcium (Ca) level was 5.7 mg/dl, phosphorus (P) 5.0 mg/dl, and fasting blood glucose 308 mg/dl, but urinary ketone bodies were not detected. High sensitive assay of parathyroid hormone (HS-PTH), intact PTH and C-terminus PTH concentrations were under the level of detection. TSH level was slightly high (6.1 mu U/ml) with positive antimicrosomal and antithyroglobulin antibodies but thyroid hormone levels were within normal limits. TRH test showed over-response of TSH. Based on Ellsworth-Howard test, we made the diagnosis of idiopathic hypoparathyroidism associated with primary hypothyroidism and diabetes mellitus. He was treated with insulin twice a day and reached good control, and he was also administered 1 alpha-OH-D3 and calcium lactate resulting in an increase of serum Ca level after 2 weeks. These findings suggest that this case may be a polyglandular autoimmune (PGA) syndrome type 1 reported by Neufeld, which is very rare in Japan. The type of diabetes mellitus of this case is controversial. It is, however, necessary to pay attention to the decrease of the patient's insulin-secreting activity because autoimmune disorders are accompanied by this case.

Removal of maternal antibodies from a woman with repeated fetal loss due to P blood group incompatibility

BACKGROUND

Plasmapheresis is intended to lower plasma antibody levels in women with blood group incompatible pregnancies.

CASE REPORT

Therapeutic specific antibody removal by using antigen-positive red cells was applied to a blood group p pregnant women who had a high titer (128) of IgG anti-PP1Pk and had lost all six previous fetuses in blood group P-incompatible pregnancies. Plasma was taken from the patient with an intermittent-flow cell separator, mixed with a volume of washed and packed P-positive red cells equivalent to one-fifth of the volume of plasma, and incubated for 10 minutes in an ice water bath. The PP1Pk antibodies were removed, and the autologous plasma was transfused. Treatment by specific antibody removal was started in the seventh week of gestation, and performed one to three times a week for a total of 56 times up to the 34th week. The volume of plasma treated was 2.4 L per procedure on average and totaled 135 L. After each treatment, the antibody titer in the patient's plasma usually decreased by 1 log2, and no deleterious effect on the women was noted. The titers of IgG anti-P and anti-Pk were kept between 4 and 16 after the ninth week of gestation. At the end of the 34th week of gestation, a male infant was delivered by cesarean section. The infant did not require an exchange transfusion and is now a healthy 2-year-old boy.

CONCLUSION

This therapeutic method is very useful in the management of fetomaternal P-incompatibility.

[Dynamic focusing of informational convergence in basal ganglia]

Data in the literature support two apparently contradictory hypotheses: that of parallel processing and that of informational convergence in the basal ganglia. We present electrophysiological data supporting one and the other. Thus, at the output of the basal ganglia, in the intact monkey, neurons of the pallidum respond almost exclusively and in small number to passive limb movement. The specificity of the responses supports the parallel processing hypothesis. However, when the monkey is rendered parkinsonian by the neurotoxin MPTP, the dopaminergic deficit discloses a strong convergence upon pallidal neurons of information originating from different body parts. Such a convergence is also observed in the case of pallidal responses to electrical stimulation of the striatum. According to data in the recent literature, it is more likely that this information converges into the pallidum through the subthalamo-pallidal rather than the striato-pallidal pathway. On the other hand, pallidal responses to electrical stimulation of the striatum display a topological antagonistic center-surround organization, probably resulting from lateral inhibition. Moreover, changes in neuronal activities induced in the external pallidal segment by local injection of bicuculline display a similar organization and suggest the occurrence of a wide and powerful lateral inhibition in this pallidal segment. Such focusing mechanisms would be useless in an exclusively parallel system. One may therefore think that, in the normal individual, the level of dopamine dynamically focuses the system on the appropriate information. This would allow parallel processing in neuronal channels that are only relatively independent, since they can also demonstrate informational convergence.