Progressive multifocal leukoencephalopathy. A case report and review of the literature

Progressive multifocal leukoencephalopathy developed in a 70-year-old man with hepatoma treated with oncostatica. The brain showed multiple demyelinated lesions in the upper half of the cerebral white matter. The lesions consisted of proliferation of hypertrophied astrocytes and glial cells with abnormally large nuclei. These nuclei were shown to be filled with DNA by DAPI staining and reacted specifically with anti-JC antibody by immunofluorescence. Papova-like virions were confirmed on both the sections and negatively-stained brain extract under electron microscopy. The sixteen cases so far reported in Japan were reviewed.

Asparenomycins A, B and C, new carbapenem antibiotics. II. Isolation and chemical characterization

New carbapenem antibiotics named asparenomycins A, B and C were isolated from the fermentation broths of Streptomyces tokumonensis sp. nov. and of Streptomyces argenteolus. The fermentative production, isolation and physico-chemical properties of these antibiotics are described.

The Onuf's nucleus and the external anal sphincter muscles in amyotrophic lateral sclerosis and Shy-Drager syndrome

The anterior sacral horns and external anal sphincter muscle were examined histologically with special reference to Onuf's nucleus in amyotrophic lateral sclerosis (ALS) and Shy-Drager syndrome. Onuf's nucleus and the external anal sphincter muscles were well preserved in ALS, but in Shy-Drager syndrome both structures showed marked degenerative changes. These findings suggest that Onuf's nucleus does not belong to the autonomic neurons, but to the motoneurons in anterior sacral horn, and it innervates the external sphincter muscles of the anus and urethra.

Retinal amacrine cell involvement in Tay-Sachs disease

Ultrastructural study of the retina from a patient with Tay-Sachs disease disclosed that amacrine cells as well as ganglion cells were loaded with numerous membranous cytoplasmic bodies, suggesting an accumulation of GM2 ganglioside, whereas the horizontal cells, bipolar cells, and photoreceptor cells were intact. Chromatography of lipids from the retina showed a prominent spot of GM2 ganglioside. These facts suggest that lipid metabolism in amacrine cells may be different from that in other retinal cells.

Progressive multifocal leukoencephalopathy. Neuropathology and virus isolation

Mechanism of demyelination in progressive multifocal leukoencephalopathy (PML) was elucidated by demonstrating ultrastructurally the relationship between the affected glial cells and myelin sheaths. The myelinating cells in the central nervous system, namely oligodendroglias, were specifically attacked by PML-virus with eventual primary destruction of myelin sheaths. An attempt to isolate PML-virus from the autopsy material was made. The presence of virus particles in the extracts from the brain, reactions of virions with antibodies and evidence of virus proliferation in the primary human fetal glial cell culture were shown by various techniques including negative staining, immunofluorescence, immunoelectron microscopy, and electron micrography. The isolated virus was antigenically identical with JC type of papovaviruses.

Factors influencing yield of plateletpheresis by discontinuous centrifugation

Plateletphereses performed by the Haemonetics Model 30 Blood Processor under a fixed condition were retrospectively analyzed. The mean platelet yield was 5.97 X l0 (ll) (+/- l.46 X l0 (ll). Prepheresis platelet count was significantly correlated to platelet yield (p less than 0.001), but hematocrit was not (p greater than 0.1). Blood-drawing time showed a significant correlation (p less than 0.01) and may suggest than an infusion rate of 60 ml/minute is a technique of choice. A large number of platelets (% platelet recovery = 73.0 +/- l4.l%) was discarded in order to remove erythrocytes and leukocytes from the initial product. The recovery was negatively correlated to the percentage removal of leukocytes (p less than 0.01), which means that a platelet product of good quality not containing leukocytes can be prepared at the sacrifice of a large quantity of platelets. It is desirable to devise a simple and practical technique to obtain pure platelets without loss.

Potentiation of neurovirulence of canine distemper virus in guinea pigs by sensitization with neural antigen

Establishment of animal model of virus-induced encephalomyelitis was attempted in strain 13 guinea pigs sensitized with the homologous spinal cord antigen. Intracerebral inoculation of canine distemper virus alone or sensitization with the neural antigen alone did not induce significant clinical signs. Mild histological lesions were found in both the meninges and parenchyma of the central nervous system (CNS) of virus-infected animals, and in the meninges of the sensitized ones. In contrast, combination of virus infection and sensitization resulted in development of neurological signs of CNS disease as well as of marked histological lesions involving both the meninges and parenchyma. The potentiated CNS disease was successfully transferred by the lymph node cells of the sensitized animals into virus-infected ones. These results suggested that the virus-induced lesions in the CNS were potentiated by the lymphocytes sensitized with neural antigen. Depending on the time schedule of the sensitization and virus infection, different courses of CNS diseases including acute, subacute, and/or recurrent ones were induced, indicating the usefulness of this animal model for immunological and virological analysis of virus-induced CNS diseases.

Establishment of a persistently infected cell line with Rinderpest virus

Persistent infection of rinderpest virus in Vero cells was established and designated as VRP34. Virus specific antigens were present in nearly 100 per cent of the cells. Cytopathic effect (CPE) consisting of syncytium formation and vacuolation is a unique feature of VRP34. Spontaneously released virus mainly consisted of non-temperature-sensitive virus populations and was able to initiate persistent infection in both normal Vero and RK13 cells. The results indicate that mutation of virus is responsible for the establishment of persistent infection.

[When does the brain atrophy in Creutzfeldt-Jakob disease? (author's transl)]

Chronological changes of computerized tomography (CT) findings and clinical signs and symptoms were studied in 3 patients of Creutzfeldt-Jakob disease. CT revealed no brain atrophy in the stage when the patients showed frequent myoclonus and fell rapidly into the state of akinetic mutism. One autopsied case of this stage showed no macroscopical brain atrophy at all. Microscopical examination revealed extensive spongiform change in cerebral cortices (except for hippocampus), thalamus, basal ganglia, midbrain and a part of cerebellar cortex, but neuronal loss and gliosis were not severe. In other 2 cases conspicuous brain atrophy was noted in CT several months after this rapidly worsening period. Therefore when discussing pathological findings of Creutzfeldt-Jakob disease, we must consider when the patient died in the clinical course of this disorder.

Characterization of the cytoplasmic inclusion bodies of the spleens from patients with adult form Gaucher's disease

The twisted tubular cytoplasmic inclusion bodies were isolated from spleens of four patients with adult form Gaucher's disease. The chemical composition of the CIB (cytoplasmic inclusion bodies) was as follows: proteins, 10%, cholesterol, 10%, phospholipids, 10%, glycolipids, 70%. More than 90% of glycolipids from CIB were glucosylceramide. The structural protein profile of these bodies was examined by SDS-polyacrylamide disc gel electrophoresis on a semimicro-scale (s-PAGE). A similar protein composition which included two glycoproteins was found in all the four cases. The tubular structure of the bodies was changed to a small and round form by the treatment with 1 mM EDTA-Na2 which removed some structural proteins from the bodies. This indicated that some proteins might have an important role in maintaining the tubular structure of CIB.

Vasovagal reactions in blood donors

The donor records of a hospital blood bank, analyzed from a statistical standpoint demonstrated a low incidence of vasovagal reactions: 119 in 10,547 donations (1.13%). Donors of younger age and of lower diastolic blood pressure were more prone to reaction. There was no significant sex difference. Higher reaction rates were also associated with first-time donation, the time of year (spring), and a particular phlebotomist. The low reaction rate and the clearly demonstrated psychologic factors in the present study were attributed to a reflection of the small amount (200 ml) of blood withdrawn. The importance of the phlebotomist-donor relationship was stressed.

Enzymic determination of free fatty acids in serum

We describe the enzymic determination of free fatty acids in serum with use of acyl-CoA synthetase (EC l.2.1.3), acyl-CoA oxidase (no EC no. assigned) and peroxidase (EC 1.11.1.7). The free fatty acids are activated by acyl-CoA synthetase in the presence of ATP and coenzyme A. The acyl-CoA formed is oxidized by acyl-CoA oxidase to enoyl-CoA with simultaneous production of hydrogen peroxide, which is oxidatively coupled with 4-amino-antipyrine and 2,4-dibromphenol in the presence of peroxidase to yield a product that absorbs maximally at 505 nm. Standard curves prepared with various kinds of fatty acids are linear to at least 2.0 mmol/L and are practically congruent. Ascorbic acid or bilirubin interferes slightly. Results by the present method correlate well with those by the colorimetric method involving 2-(2-thiozolylazo)-p-cresol (r = 0.98). Replicate analyses of standard solution and of two kinds of control sera demonstrated the following between-assay precision: mean absorbance 0.224 (SD 0.002), CV 0.85%; mean concentration, 326 (SD 7.3) and 1076 (SD 22.7) mumol/L, CV 2.24 and 2.11%, respectively.

Enzymic determination of free fatty acids in serum

We describe the enzymic determination of free fatty acids in serum with use of acyl-CoA synthetase (EC l.2.1.3), acyl-CoA oxidase (no EC no. assigned) and peroxidase (EC 1.11.1.7). The free fatty acids are activated by acyl-CoA synthetase in the presence of ATP and coenzyme A. The acyl-CoA formed is oxidized by acyl-CoA oxidase to enoyl-CoA with simultaneous production of hydrogen peroxide, which is oxidatively coupled with 4-amino-antipyrine and 2,4-dibromphenol in the presence of peroxidase to yield a product that absorbs maximally at 505 nm. Standard curves prepared with various kinds of fatty acids are linear to at least 2.0 mmol/L and are practically congruent. Ascorbic acid or bilirubin interferes slightly. Results by the present method correlate well with those by the colorimetric method involving 2-(2-thiozolylazo)-p-cresol (r = 0.98). Replicate analyses of standard solution and of two kinds of control sera demonstrated the following between-assay precision: mean absorbance 0.224 (SD 0.002), CV 0.85%; mean concentration, 326 (SD 7.3) and 1076 (SD 22.7) mumol/L, CV 2.24 and 2.11%, respectively.

Primary Hodgkin's disease of the falx cerebri

A case of the falx tumor of a 60-year-old man is reported. The tumor consisted of a pleomorphic mixture of lymphoid cells, histiocytes, atypical reticulum cells, and bizarre giant cells, including the diagnostic Reed-Sternberg cells. No transitional forms among these cells were observed. This is the first report of primary Hodgkin's disease of the dura matter, as verified by complete necropsy.

Ultrastructural study of myelinating cells and sub-pial astrocytes in developing rat spinal cord

The anterior funiculus of the spinal cervical cord of post-natal rats was examined ultrastructurally. The myelinating cells found one day after brith contained a large amount of evenly distributed ribosomes up to the outer tongue of mesaxons, representing the cytoplasmic density. These cells were separated by astrocytic processes from the pial basement membrane, even when they were located on the pial surface. Astrocytes contained glial fibrils from one day onwards and often attached their processes to the pial basement membrane. Although the cytoplasmic processes of astrocytes occasionally wrapped axons, they were never shown to form the initial layer of myelin sheaths. However, the tenuous processes of the sub-pial astrocytes were occasionally rolled in myelin lamellae, as if a part of the myelin sheaths was constructed by astrocytic processes. The interpretation for this finding is discussed in relation to function and potency of the astrocytes, and variations and anomalies of nervous ontogeny.