Visual form agnosia in multiple sclerosis

We report a case of multiple sclerosis with visual form agnosia and callosal syndromes. Initially, the patient's visual recognition of object form was severely disturbed at the perceptual stage, in association with left-sided ideomotor apraxia and agraphia. Magnetic resonance imaging showed large white matter lesions in the bilateral frontal and occipital lobes, the latter extending to the occipitotemporal junction, and widespread corpus callosum lesions. Over the course of one year follow-up, neuropsychological examinations indicated that the patient's visual recognition defects occurred not only at the early substage of form perception, but also at the stage of reproducing the shape of objects from visual memory store. The present case suggests that neural connections between the striate cortex and occipitotemporal visual areas are crucial for both the perceptual and associative stages of visual object recognition.

Effect of the type of serum in the medium on sodium ascorbate-induced cytotoxicity

Sodium ascorbate induced cytotoxicity against human glioblastoma T98G cells in RPMI1640 medium supplemented with fetal bovine serum or human serum samples was studied. Several human serum samples significantly reduced the cytotoxic activity of sodium ascorbate, regardless of sex, age or the disease of the serum donor with or without heat-inactivation of the serum. ESR spectroscopy revealed that this serum effect was not simply due to the alteration of the ascorbyl radical intensity, produced from sodium ascorbate. The present study suggests that the apoptosis-inducing activity of sodium ascorbate might be significantly affected by human serum.

[Clinical and immunological effects of leukapheresis therapy using cotton-wool filter for patients with rheumatoid arthritis]

Remarkable clinical effectiveness of leukapheresis (LP) using a cotton-wool filter as a therapy for patients with rheumatoid arthritis (RA) was previously reported. To study the mechanism and indications for this therapy, 14 patients with RA were treated with this filter 6 times at 2 weeks intervals. The effects on clinical symptoms and subpopulations of peripheral blood mononuclear cells were evaluated on day 0, 3, 7, 14, 42 and 84. The Ritchie articular index, swollen joint counts, Lansbury index and health assessment questionnaire (HAQ), all showed improvements within the first week and the improvements were still observed 3 month later. Improvements in tender joint counts and visual analog pain scale (VAPS) were also observed on day 84. Eight patients showed remarkable improvements (responders) and 6 showed no apparent improvement (non-responders) according to the ACR core set criteria. Responders showed several characteristic features compared to non-responders as follows: the duration of RA was significantly shorter, the anatomical stage was earlier, the positive rate of susceptible HLA-DR4 haplotype associated with Japanese RA (DRB1*0405) was lower, and the proportion of CD4 + Leu8 + lymphocytes and the ratio of CD4+ cells to CD8+ cells (CD+/CD8 ratio) in the peripheral blood were higher throughout the treatment period and increased further even after the course of therapy. The proportion of CD4 + Leu8 + cells was inversely correlated with HAQ and VAPS, suggested that it is critically involved in the mechanism of this therapy. Blood leukocyte analysis at inlet and outlet of the filter showed increase of CD4 +, CD4 + Leu8 + cell percentages and CD4/CD8 ratio. These results suggested that patients with a shorter disease duration, less destruction of the joint, and without susceptible genes were more responsive to this therapy and that the mechanism of clinical improvement of RA by LP with cotton-wool involves immunological modification, such as immunosuppression by CD4 + Leu8 + lymphocytes.

A YAC contig of the human CC chemokine genes clustered on chromosome 17q11.2

CC chemokines are cytokines that attract and activate leukocytes. The human genes for the CC chemokines are clustered on chromosome 17. To elucidate the genomic organization of the CC chemokine genes, we constructed a YAC contig comprising 34 clones. The contig was shown to contain all 10 CC chemokine genes reported so far, except for one gene whose nucleotide sequence is not available. The contig also contains 4 CC chemokine-like genes, which were deposited in GenBank as ESTs and are here referred to as NCC-1, NCC-2, NCC-3, and NCC-4. Within the contig, the CC chemokine genes were localized in two regions. In addition, the CC chemokine genes were more precisely mapped on chromosome 17q11.2 using a somatic cell hybrid cell DNA panel containing various portions of human chromosome 17. Interestingly, a reciprocal translocation t(Y;17) breakpoint, contained in the hybrid cell line Y1741, lay between the two chromosome 17 chemokine gene regions covered by our YAC contig. From these results, the order and the orientation of CC chemokine genes on chromosome 17 were determined as follows: centromere-neurofibromatosis 1-(MCP-3, MCP-1, NCC-1, I-309)-Y1741 breakpoint-RANTES-(LD78gamma, AT744.2, LD78beta)-(NCC-3, NCC-2, AT744.1, LD78alpha)-NCC-4-retinoic acid receptor alpha- telomere.

[Clinical studies of inverted papilloma of the bladder]

Clinical studies were conducted on 9 cases of inverted papilloma of the urinary bladder which were transurethrally resected between August, 1987 and July, 1995 at our hospital, in males between 29 and 81 years of age (mean:58.3). Six of the 9 inverted papillomas were localized at the bladder neck and 3 in the trigone. Cystoscopic examinations revealed that inverted papillomas were divided into two types, one with a thick and short stalk with a smooth surface and the other with a thin and long stalk with/without a partial papillary surface. The majority of the former was located in the trigone and all of the latter cases in the bladder neck, suggesting that the two types occurred at different sites. Pathological examination by Hematoxylin-Eosin staining demonstrated that 5 of the 9 cases were of the trabecular type and 4 were of the grandlar type. Immunohistochemically, none of the tumors were stained with the antiprostatic-specific-antigen antibody revealed. Follow-up periods after the operation were from 12 to 48 months(mean:26.6 months) and no recurrence was observed.

Chromatin structure and endonuclease sensitivity in human leukemic cell lines

The relationship between chromatin structure and endonuclease sensitivity was investigated. The cells used in this study were a) human myelogenous leukemic cell lines (HL-60, ML-I, U-937, THP-I) (Group I), which produced internucleosomal DNA cleavage, and b) human T-cell leukemia (MOLT-4), erythroleukemia (K562), glioblastoma (T98G, U87MG) and glioma (KG-1-C) cell lines (Group II), which produced no internucleosomal DNA cleavage, upon treatment with various apoptosis-inducing agents. When the nuclei, isolated from these cells were digested with micrococcal nuclease, chromatin DNA was cleaved into oligonucleosomal units. Although sensitivity to micrococcal nuclease considerably differed from cell to cell, Group I cells were generally more sensitive to micrococcal nuclease digestion than Group II cells. Similar sensitivity to DNase I was observed in both groups of cells. Acid-urea polyacrylamide gel electrophoresis of histone fractions from control and apoptosing HL-60 cells (induced either by hydrogen peroxide or UV irradiation) revealed no significant change in the relative composition of five major histones, indicating the absence of selective degradation of histone HI, but rather the nonspecific degradation of many nuclear proteins. These data suggest a difference in a chromatin structure between Group I and II cells, which might result in the selective production of internucleosomal DNA cleavage only in Group I cells.

Changes in aerobic capacity and coronary risk factors during long-term exercise training in women with ischemic heart disease: a 36-month follow-up

We evaluated the time course of alteration in aerobic capacity and coronary risk factors associated with a 36-month exercise program in women with ischemic heart disease (IHD). Twenty-one patients participated in supervised exercise and home-based exercise programs for 36 months. However, of all patients, 11 patients completed the entire program. Oxygen uptake corresponding to lactate threshold (VO2LT), peak oxygen uptake (VO2peak), percent of body fat (%BF), systolic (BPs) and diastolic (BPd) blood pressure, total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC) and triglycerides (TG) were assessed before and 4, 8, 12, 24, and 36 months after exercise. The intensity of exercise was set at individually determined LT, i.e., 60 to 70% VO2peak. The daily amount of exercise during 36 months averaged 24.0 +/- 11.4 minutes per day. During the course of exercise program, VO2LT, VO2peak, BPs, BPd, and TG improved significantly at month 4. Although %BF decreased significantly at month 8 to 12, it tended to return to the initial level at month 36. On the other hand, a significant increase in HDLC was found at month 24 and improved state of HDLC remained unchanged thereafter. No changes were found in TC and LDLC. These results suggest that most of the beneficial effects of exercise on aerobic capacity and coronary risk factors in women with IHD are obtained within 4-8 months, with some further improvement seen with continued exercise up to 24 months.

Three different mutations of presenilin 1 gene in early-onset Alzheimer's disease families

Presenilin-1 (PS-1) gene of three Japanese pedigrees with early-onset familial Alzheimer's disease (FAD) disclosed two novel missense mutations resulting in Val96Phe and Ile213Thr, and one mutation resulting in His163Arg. The mean age at onset in a family with His163Arg mutation was similar to those reported in other families with His163Arg. Our results suggested the existence of a variety of PS-1 mutations, and that early-onset FAD with PS-1 mutations is highly penetrant and is only rarely subject to modulation by genetic or environmental modifying factors.

Histochemical, lectin-histochemical and morphometrical characteristics of intestinal goblet cells of germfree and conventional mice

Histochemical, lectin-histochemical and morphometrical studies were carried out on intestinal goblet cells of 8-week-old germfree (GF) and conventional (CV) mice of the BALB/c strain. Except for the reactivity of cecal goblet cells to Dolichos biflorus agglutinin (DBA) and Ulex europeus-I agglutinin (UEA-I), there was no difference between GF and CV mice in histochemical and lectin-histochemical properties. In the cecal mucosa, DBA stained the goblet cells strongly in CV mice but not in GF mice and UEA-I stained the goblet cells strongly in the lower part of crypts in CV mice but only faintly in GF mice. These findings suggest that terminal residues of cecal goblet cell mucin were different in GF and CV mice. Morphometrically, cecal goblet cells were fewer in number and smaller in size in GF mice than in CV mice. In addition, high iron diamine-alcian blue staining made a very clear border between the cecum and colon, because cecal goblet cells were exclusively positive for sulfomucin and colonic goblet cells were predominantly positive for sialomucin.

KW-3902, a selective high affinity antagonist for adenosine A1 receptors

1. We demonstrate that 8-(noradamantan-3-yl)-1,3-dipropylxanthine (KW-3902) is a very potent and selective adenosine A1 receptor antagonist, assessed by radioligand binding and cyclic AMP response in cells. 2. In rat forebrain adenosine A1 receptors labelled with [3H]-cyclohexyladenosine (CHA), KW-3902 had a Ki value of 0.19 nM, whereas it showed a Ki value of 170 nM in rat striatal A2A receptors labelled with [3H]-2-[p-(2-carboxyethyl)-phenethylamino]-5'-N-ethylcarboxamidoad enosine (CGS21680), indicating 890 fold A1 receptor selectivity versus the A2A receptor. KW-3902 at 10 microM showed no effect on recombinant rat A3 receptors expressed on CHO cells. 3. Saturation studies with [3H]-KW-3902 revealed that it bound with high affinity (Kd = 77 pM) and limited capacity (Bmax = 470 fmol mg-1 of protein) to a single class of recognition sites. A high positive correlation was observed between the pharmacological profile of adenosine ligands inhibiting the binding of [3H]-KW-3902 and that of [3H]-CHA. 4. KW-3902 showed potent A1 antagonism against the inhibition of forskolin-induced cyclic AMP accumulation in DDT1 MF-2 cells by the A1-selective agonist, cyclopentyladenosine with a dissociation constant (KB value) of 0.34 nM. KW-3902 antagonized 5'-N-ethylcarboxamidoadenosine-elicited cyclic AMP accumulation via A2B receptors with a KB value of 52 nM. 5. KW-3902 exhibited marked species-dependent differences in the binding affinities. The highest affinity was for the rat A1 receptor (ki = 0.19 nM) and these values for guinea-pig and dog A1 receptors were 1.3 and 10 nM, respectively.

[Nephron sparing surgery for synchronous and asynchronous bilateral renal cell cancer. A procedure using intraoperative ultrasonography, argon beam coagulator and fibrin glue]

BACKGROUND

Bilateral renal cell cancer (RCC) is an imperative indication of nephron sparing surgery (NSS). In the present study, we examined a new modality for NSS; intraoperative ultrasonography, argon beam coagulator (ABC) and fibrin glue.

PATIENTS AND METHODS

We performed NSS against 7 kidneys in 5 patients, including 3 with synchronous and 2 with asynchronous tumors. Radical nephrectomy was performed on the contralateral kidney in 2 patients including one with asynchronous and the other with synchronous RCC.

RESULTS

To examine satellite lesions and exact tumor extent within the kidney, intraoperative ultrasound scan was performed for all cases. Intraoperative ultrasound scan was shown to be useful for the above mentioned purposes because of its high resolving power. After clamping of the renal artery and surface cooling, dissection of the kidney was done by knife holder or by ultrasonic aspirator. Hemostasis was made by figure eight sutures with chromic catgut or poliglecaprone 25 monofilament, followed by coagulation using ABC, and with fibrin glue. Duration of arterial clamp ranged 20 approximately 78 min under surface cooling. Major complication did not occur except urinary fistula in one case caused by inadequate placement of a double J ureteral catheter. Postoperative renal functions were well preserved and any additional therapy for daily life was not needed in each patient.

CONCLUSION

For performing NSS, the use of intraoperative ultrasound scan, ultrasonic aspirator, ABC and fibrin glue seemed to be useful, encouraging us to widespread its indication.

Depletion of Mac1-positive macrophages protects DBA/2 mice from encephalomyocarditis virus-induced myocarditis and diabetes

DBA/2 mice treated with anti-Mac1 monoclonal antibody (MAb) failed to develop encephalomyocarditis virus (EMCV)-induced diabetes and myocarditis. Virus concentrations and the number of viral RNA-positive cells in the pancreas and heart were significantly reduced in mice treated with anti-Mac1 MAb. Mac1-positive macrophages seem to be involved in EMCV-induced disease and to affect the replication of EMCV in target organs.

The terminal protein of the linear DNA plasmid pGKL2 shares an N-terminal domain of the plasmid-encoded DNA polymerase

The 36K protein attached at the 5' end of the linear DNA plasmid pGKL2 from the yeast Kluyveromyces lactis was first purified and characterized. The terminal protein was purified from cells (1 kg wet weight) by ammonium sulphate precipitation and two rounds of centrifugation to equilibrium in CsCl gradients. The pGKL2 was present only in the post-microsomal supernatant. Approximately 10 mg of the purified pGKL2 was recovered and digested with DNase I. The terminal protein (final ca. 0 center dot 8 mg) was homogeneous by electrophoresis and we determined the N-terminal amino acid sequence up to ten residues, showing that it existed in the cryptic N-terminal domain of pGKL2-ORF2 (DNA polymerase) sequence.

Mutational screening of APP gene in patients with early-onset Alzheimer disease utilizing mismatched PCR-RFLP

To elucidate the frequency of mutations of the beta/A4 amyloid protein precursor (APP) gene in early-onset Alzheimer disease, we designed a mismatched PCR-RFLP that can identify all kinds of missense mutations at codon 717 in addition to the seven kinds of known mutations at exon 17. When we screened mutations at exon 17 utilizing this method and the double missense mutations at exon 16 of the APP gene by PCR-RFLP, no cases revealed mutations of the APP gene among 13 familial and 54 sporadic cases, except one family (OS-1) that had previously been reported and used as a positive control of APP717(Val-->Ile). Our results support the hypothesis that mutations in the APP gene are not major causes in early-onset Alzheimer disease.