Dilemma in the treatment of Parkinson's disease with L-dopa

L-Dopa pioneered the symptomatic therapy of Parkinson's disease. While this treatment proved effective in the treatment of parkinsonian akinesia, rigidity and tremor, prolonged L-dopa treatment was often noted to result in dyskinesia, psychosis and 'on-off' phenomena. This increasing disability of L-Dopa-treated parkinsonian patients, however, is not correlated with the duration of L-dopa treatment. Mortality due to Parkinson's disease has decreased significantly after the introduction of L-dopa treatment. The development of D1-selective dopamine agonists and the introduction of neuroprotective rather than symptomatic therapy are required for treating Parkinson's disease.

Seven-year follow-up study of bromocriptine therapy for Parkinson's disease

A 7-year nationwide study of bromocriptine monotherapy and combination therapy with bromocriptine and levodopa in Parkinson's disease is reported. Of 22 patients who had been on bromocriptine monotherapy for 7 years (group B), 16 remained improved or remained in the same stages of Hoehn and Yahr, and no wearing-off phenomenon or dyskinesia was observed. In another 56 patients who were started on bromocriptine alone, but in whom combination therapy with levodopa was instituted at some time in the 7 years (group BL), disease progressed faster than in group B. A wearing-off phenomenon and dyskinesia occurred in 34% and 5.4% of the patients, respectively. These manifestations appeared only after initiation of levodopa. The favorable course of group B suggests possible neuroprotective effects of bromocriptine or may be due to the inevitable selection of patients who had a favorable course originally.

Pallidonigroluysian degeneration with iron deposition: a study of three autopsy cases

In the basal ganglia of three autopsy cases of pallidonigroluysian degeneration, we found marked iron deposition, a finding which has not been mentioned previously in the literature. Besides severe astrogliosis and neuronal loss in the pallidum, Luysian body and nigra, granular deposits of brown pigments were found in the neuropil, microglias, oligodendrocytes and astrocytes in three such the nuclei and the striatum. These brown pigments proved histochemically to be iron. Our histochemical semiquantitative study showed a significantly stronger reaction for iron in the degenerated nuclei in these three cases than in control cases comprising non-degenerative and the other degenerative diseases. Quantitative study with inductively coupled emission spectrometry also demonstrated a markedly higher iron content in the globus pallidus and the striatum in comparison with the control cases. The possibility is discussed that iron deposition plays a role in generating the lesions of pallidonigroluysian degeneration.

[Parkinsonian tremor, rigidity and flapping tremor]

Tremor occurring at rest (4-6 Hz) is considered to be one of the most characteristic symptoms in patients with Parkinson's disease. Yet, an early stages of the disease only 50% of the patients manifest resting tremor. Indeed, about 15% of Parkinsonian patients never display tremor at any stage of the disease. If tremor is present, its type is essential for differential diagnosis. Pill-rolling movement, for instance, is a hallmark of Parkinson's disease. Parkinsonian patients often show postural tremor associated with certain postures or movement, whereas flapping tremor is indicative of metabolic (ex: hepatic) encephalopathy. Parkinsonian rigidity is unique muscular rigidity. If rigidity is abolished by L-dopa or dopamine agonists, this provides a reliable sign for diagnosis of Parkinson's disease. Pathophysiology of different types of tremor is briefly discussed.

Rotations induced by L-dopa in parkinsonian rats are reduced by an ingestion of amino acids

We studied the effect of amino acid load on L-dopa-induced rotational behavior in rats with unilateral lesion of the nigrostriatal pathway. Pretreatment of rats with an ingestion of high concentration of amino acids significantly reduced the number of rotations induced by subcutaneously injected L-dopa. These results provide the experimental basis for clinical observations that dietary protein affects the response to L-dopa in parkinsonian patients.

Effect of D-penicillamine on pharmacokinetics of levodopa in Parkinson's disease

A 42-year-old man had suffered from Parkinson's disease for 5 years. Levodopa was effective, but the wearing-off phenomena were severe. Because of relatively low levels of serum copper and ceruloplasmin, D-penicillamine was administered. D-penicillamine increased plasma levodopa concentrations, thereby improving his parkinsonian symptoms. We propose that D-penicillamine facilitates levodopa absorption and, hence, the efficacy of the antiparkinsonian drug.

Effects of terguride, a partial D2 agonist, on MPTP-lesioned parkinsonian cynomolgus monkeys

Behavioral effects of terguride, a partial dopamine D2 agonist, on 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-lesioned parkinsonian cynomolgus monkeys were compared with those of the dopamine agonist apomorphine and the dopamine antagonist haloperidol. Terguride alone ameliorated the parkinsonism without inducing any sign of excitability, irritability, or aggressiveness (hyperactivity). Apomorphine alone also ameliorated the parkinsonism but induced marked hyperactivity. Haloperidol alone caused worsening of the parkinsonism, inducing transient eyelid closure. In combination with apomorphine, terguride suppressed the hyperactivity induced by apomorphine without reducing its antiparkinsonian effects. Pretreatment with haloperidol suppressed both the antiparkinsonian effects and the hyperactivity induced by apomorphine. Terguride thus exhibits both antiparkinsonian and antihyperactivity effects in a monkey model of Parkinson's disease, suggesting that terguride might be beneficial for treating motor dysfunction and dopaminergic psychosis in advanced Parkinson's disease.

Neuroleptic malignant syndrome in a parkinsonian woman during the premenstrual period

A 45-year-old woman with Parkinson's disease developed neuroleptic malignant syndrome (NMS) despite lack of levodopa withdrawal. She experienced two episodes characterized by indomethacin-resistant hyperthermia, hyperhidrosis, and aggravation of parkinsonism. The symptoms, however, disappeared during menstruation. We suggest that the development of NMS may depend, in part, upon the hormonal state.

The dopamine D1 receptor agonist SKF 38393 suppresses detrusor hyperreflexia in the monkey with parkinsonism induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)

A pharmacological study using monkeys, in which parkinsonism was induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), was undertaken to elucidate the mechanism underlying urinary bladder dysfunctions in Parkinson's disease. Under ketamine anesthesia, cystometrograms showed that, in MPTP-treated monkeys, a contraction of the urinary bladder was induced with smaller bladder volume than that in normal monkeys. In MPTP-treated monkeys, subcutaneously injected SKF 38393, a dopamine D1 receptor agonist, significantly increased the bladder volume and pressure thresholds for inducing the micturition reflex without affecting those in normal monkeys. In contrast, subcutaneous injections of quinpirole, a dopamine D2 receptor agonist, and apomorphine, a dopamine D1 and D2 receptor agonist, slightly, but significantly reduced the volume threshold of the bladder for the micturition reflex in both normal and MPTP-treated groups. These results indicate that, in parkinsonism, the degeneration of dopaminergic neurons in the substantia nigra leads to the detrusor hyperreflexia, probably due to a failure of activation of dopamine D1 receptors.

Progress note on Japanese multicenter bromocriptine monotherapy

The nationwide multicenter collaborative study for evaluating the monotherapy of Parkinson's disease with bromocriptine for a period of 5 years from 1986 was reviewed last year. The present report summarizes the follow-up in its 6th year: it includes 30 patients with Parkinson's disease who continued to receive bromocriptine monotherapy for 6 years and 66 patients who received bromocriptine-levodopa combination therapy during the same period. The mean daily dose of bromocriptine in the 6th year was about the same in the two groups (11.9 and 12.2 mg). In terms of Hoehn-Yahr's severity grade, severity increased in 20% of the patients undergoing bromocriptine monotherapy, whereas of the patients in the bromocriptine-levodopa combination group it was 45%. Wearing-off phenomenon was not seen in the bromocriptine monotherapy group. By contrast, 30% of the patients in the combination therapy group manifested this phenomenon which, when it occurred, invariably followed the administration of levodopa. Absence of the wearing-off phenomenon implies that bromocriptine has a direct protective action on degenerating substantia nigra.

Therapeutic effects of arotinolol, a beta-adrenergic blocker, on tremor in MPTP-induced parkinsonian monkeys

The effect of arotinolol, a peripherally acting beta-adrenergic-blocking agent, on postural or kinetic tremor was studied in monkeys with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced parkinsonism. Male cynomolgus monkeys (Macaca fascicularis) were treated with three injections of MPTP hydrochloride (0.3 mg/kg, i.v.) at an interval of 3-4 days, followed by several injections of the same dose every 7 days. Four monkeys with persistent parkinsonian symptoms manifested for greater than 1 year were used. The animals developed mild to moderate degrees of postural or kinetic tremor, and their motor activity was reduced. Arotinolol (20-30 mg/kg, s.c.) significantly suppressed postural tremor in a dose-dependent manner. Propranolol (20-30 mg/kg) was also effective in suppressing the tremor. However, the application of propranolol induced emesis, whereas arotinolol had no adverse effects. These results suggest that arotinolol is a useful adjunct to dopaminergic therapy for tremor in Parkinson's disease.

Breakdown of dynamic balance of a particle in a quadrupole cell by laser-induced aerosol heating

The retention stability of an aerosol particle in a quadrupole cell exposed to horizontal irradiation with a CO(2) laser is investigated for several sizes of single spherical carbon particles. The stability of dynamic balance for the particle levitation is affected significantly by the irradiation and breaks down at a power higher than 10(5) W/m(2). The particle is pushed away along the beam line, and its trajectory is slightly upward owing to the laser-induced aerosol heating.

Muscle energetics during exercise by 31P NMR

Previous studies have shown that a decrease in muscle tension is not proportional to decrease in the ATP concentration and free energy for ATP degradation but is proportional to the decrease in ATP consumption during muscle contraction, and that the free ADP concentration in the cell can be estimated using the Pi/PCr ratio obtained by 31P NMR. From this view, we discuss findings on muscle energetics during exercise that have been clarified by 31P NMR and its future problems.

[The intraocular pressure lowering effects of UF-021, a novel prostaglandin related compound, in animals]

The ophthalmic solution of UF-021, a novel prostaglandin (PG) related compound, was investigated for its intraocular pressure (IOP) reducing activity and local ocular side effects in different species of animals. UF-021 ophthalmic solution (0.03 to 0.24%), when topically applied to the eyes of rabbits, caused dose-dependent IOP reduction (2.8 to 5.2 mmHg), without transient IOP rise. Both in cats and monkeys, UF-021 ophthalmic solution (0.12%) elicited rapid, significant IOP reduction (ca. 9 mmHg and 2 mmHg, respectively), without any controversial, local ocular side effects being revealed. On the other hand, PGE2, PGF2 alpha-isopropyl ester all brought about marked increases in IOP prior to development of their IOP reducing activities. In addition, these primary PGs showed intense local ocular irritation, which presented a striking contrast with UF-021. Enhancement of IOP reducing activity, coupled with freedom from any significant ocular side effects, as described above, suggests that UF-021 ophthalmic solution could be promising as a new anti-glaucoma agent.

Evidence for binding of at least two factors, including T-rich strand-binding factor(s) to the single-stranded ARS1 sequence in Saccharomyces cerevisiae

To study the mechanism of initiation of eukaryotic chromosomal replication, we examined protein factors interacting with the ARS1 region located near the centromere of chromosome IV in Saccharomyces cerevisiae. Using the gel shift assay, we found protein factor(s) which specifically bound to the T-rich strand of the region containing the core consensus and its flanking sequences in ARS1, but not to the opposite strand. We designated this factor ATS (ARS1, T-rich strand-binding factor(s]. Similar specific complexes were also detected with oligonucleotide probes specific for the H4 or C2G1 ARS. As we have previously identified another binding factor, we conclude that at least two factors bind to the single-stranded ARS1 sequence.

Tears of cruciate ligaments and menisci: evaluation with cine MR imaging

A cine magnetic resonance (MR) imaging technique, involving the acquisition of kinematic sagittal images during knee movement, was used to evaluate 52 symptomatic knee joints. Results were compared with those obtained by means of static three-dimensional (3D) MR imaging. Twenty-seven of the 28 anterior cruciate ligament (ACL) tears and 22 of 24 normal ligaments were correctly identified at cine MR imaging for a sensitivity of 96% and a specificity of 92%. Static 3D MR imaging yielded a sensitivity of 71% and a specificity of 88%. All four posterior cruciate ligament tears were identified at cine and 3D MR imaging. For meniscal tears, cine MR imaging yielded a sensitivity of 48% and a specificity of 96%; the sensitivity and specificity for 3D MR imaging were 71% and 96%, respectively. Cine MR imaging proved to be more useful than static MR imaging in assessing the tightness of cruciate ligaments, especially of those that were partially torn, and in assessing the movement of meniscal-free fragments. The increased information obtained with cine MR imaging may warrant continued investigation and clinical application.

Single-strand-binding factor(s) which interact with ARS1 of Saccharomyces cerevisiae

Since plasmids containing autonomously replicating sequence(s) (ARS) can transform Saccharomyces cerevisiae cells at high frequency, ARS are considered to be the replication origins of chromosomes. To study the mechanism of initiation of eukaryotic chromosomal replication, we examined protein factors which interact with the ARS1 region located near the centromere of chromosome IV in S. cerevisiae. Using the gel-shift assay, we found protein factors which bound to a single-stranded, 97-bp fragment of the ARS1 region containing the core consensus. Competition experiments with various oligodeoxyribonucleotides (oligos) suggest that a site recognized by the factor(s) was within the element containing the core consensus and adjacent close matches to the core consensus of the minus strand. Indeed, when the oligo containing the minus strand of this element was used as a probe, two oligo-protein complexes were detected. Mutations in the core consensus reduced these binding activities. When the plus-strand oligo of the same region was used as a probe, a retarded band was also detected, but with less specific binding. Considering the fact that the core consensus and close matches to the core consensus are important for ARS function, these results imply that the protein factors detected in this experiment may participate in DNA replication.

Insolubilizing and adhesive studies of water-soluble synthetic model proteins

Insolubilizing and adhesive studies of water-soluble synthetic copoly(Tyr1 Lysx) (x = 1-10) were examined using tyrosinase in water and simulated seawater systems. Tyrosinase oxidized tyrosine aromatic nuclei, causing intermolecular crosslinking reactions, which have been assigned by the absorption band at around 360 nm. The viscosities of the model polypeptides were affected by salinity and the kinds of salts in solution systems. As a whole the amino acid compositions, salinity, system pH and beta-structure conformation are considered to play roles in the insolubilizing reaction. The bonding strengths of the model polypeptides exhibited tensile strengths of 16-24 kg/cm2 without enzyme and 29-31 kg/cm2 with tyrosinase on iron, and increased up to 10 kg/cm2 on metals by the addition of tyrosinase as an oxidant.

[MR imaging of the arm]

Thirty arms of healthy adults were studied with MR imaging using surface coil. Fine structures of the arm, such as muscular bundles, small vessels and nerves were clearly demonstrated. Deep fascia dividing muscular bundles appeared as high intensity on T1-weighed image due to fat deposition beneath the fascia. Aponeurosis is also flat sheet of densely arranged collagen fibers. With rather thicker layer of collagen fibers than fascia, aponeurosis appeared as low intensity sheet that was frequently demonstrated on MR images of the extremities.

Effect of strength training on the relationship between magnetic resonance relaxation time and muscle fibre composition

The effect of muscle hypertrophy on the relationship between magnetic resonance (MR) relaxation time and muscle fibre composition was investigated. Relaxation time and muscle fibre composition were measured in five subjects before and after a 20-week period of strength training. Muscle fibre composition in all subjects exhibited a significant shift to a predominance of fast-twitch (FT) fibres as a result of 20-week strength training (% area FT fibres: mean values from 49.8%, SD 17.9% to 57%, SD 5.6%; P less than 0.05). Longitudinal relaxation time (T1) and transverse relaxation time (T2) were prolonged significantly after strength training (T1 mean values from 334.9 ms, SD 13.6 to 359.0 ms, SD 9.0, P less than 0.001; T2 from 27.5 ms, SD 0.9 to 30.8 ms, SD 2.3, P less than 0.05). A constant relationship was observed in changes caused by strength training in muscle fibre composition (% area FT) and relaxation time, with a high correlation obtained between both parameters. These results indicate that MR relaxation time can be used for non-invasive estimation of muscle fibre composition.

Favourable associations between the myosin heavy-chain and light-chain isoforms in human skeletal muscle

Histochemical and biochemical analyses were performed in order to examine the relationship between myosin light-chain (LC) isoforms and fibre-type distributions in whole human skeletal muscle. Muscle biopsies were obtained from the vastus lateralis muscle in six healthy men, and analysed for the relative area occupied by each fibre type (percentage of fibre type area) and the molar ratio of each LC isoform. The percentage of type I fibre area was positively correlated with the molar ratio of slow LC (LC1s and LC2s) to total LC. The regression line was located below the line of unity. Also, the ratio of percentage of type IIa fibre area to that of type II fibre area was positively correlated with the molar ratio of the fast alkali LC LC1f to fast alkali LCs LC1f and LC3f. These results support previous study, having shown that in human skeletal muscle some type I fibres express various amounts of fast LC in addition to slow LC and suggest that fast myosin heavy-chain HCIIa is favourably associated with LC1f, whereas HCIIb is favourably associated with LC3f.

Binding activity and autophosphorylation of the insulin receptor from patients with myotonic dystrophy

To clarify a mechanism of insulin resistance associated with myotonic dystrophy, we studied the insulin receptor by using three different types of cells--circulating erythrocytes, cultured skin fibroblasts, and Epstein-Barr virus(EBV)-transformed lymphocytes. In myotonic dystrophy, insulin binding to erythrocytes and fibroblasts was significantly decreased as a result of a reduction of the binding affinity. Insulin binding to EBV-transformed lymphocytes was normal. When the receptors were purified from fibroblasts with wheat germ agglutinin, we could not find a decrease in the binding affinity seen in the intact cells. No difference was observed in the magnitude of basal and insulin-stimulated autophosphorylation of insulin receptors from EBV-transformed lymphocytes between the control and myotonic dystrophy. Southern blot analysis of the insulin receptor gene revealed no restriction fragment length polymorphism associated with myotonic dystrophy. These findings suggest that there is no primary defect of the insulin receptor per se in terms of insulin binding and autophosphorylation in myotonic dystrophy. The reduction of the insulin binding to erythrocytes and fibroblasts may be caused by the plasma membrane abnormality that affects the binding affinity of the receptor.

Evaluation of exercise muscle energetics by NMR

Magnetic resonance imaging (MRI) is superior to ultrasonography and X-CT especially in density resolution in soft tissue. 31P NMR provides information on metabolism, which has not been obtained in vivo by conventional methods, such as phosphocreatine (PCr), inorganic phosphate (Pi), ATP, and intracellular pH. We used MRI and 31P NMR spectroscopy to study skeletal muscle metabolism of human and rat. These NMR results suggested that 1) estimation of muscle fiber composition, 2) evaluation of muscle ATP turnover and 3) imaging of local muscle fatigue are possible.

Behavioural effects of 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) in monkeys

Subcutaneous injections of a 5-HT1A receptor agonist, 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT), in monkeys induced distinct behavioural changes characterized by head weaving, hindlimb extension and upper limb fluttering. The effects were dose-dependent and were similar to the 5-HT syndrome induced in rats by 8-OH-DPAT. The 5-HT receptor antagonist, metergoline, attenuated the behavioural syndrome seen in response to 8-OH-DPAT. These results suggest that 8-OH-DPAT induces a 5-HT1A receptor-mediated behavioural syndrome in monkeys as well as in rodents.

Oral dextran sulfate (UA001) in the treatment of the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex

STUDY OBJECTIVE

To evaluate the tolerance and safety of oral dextran sulfate (UA001), a potent in-vitro inhibitor of human immunodeficiency virus (HIV) in patients with the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex.

DESIGN

Unblinded, dose-escalation 8-week trial.

SETTING

An AIDS outpatient clinic of a university-affiliated municipal hospital.

PATIENTS

Thirty-four patients with stage III or IV HIV infection were enrolled. Five patients in six different dosage cohorts completed the study. The population was predominantly homosexual men with persistent generalized lymphadenopathy (stage III).

INTERVENTIONS

Oral dextran sulfate was given three times daily in total daily doses of 900 to 5400 mg for 8 weeks. Patients were monitored for tolerance and toxicity. Immunologic and virologic values were also followed.

MEASUREMENTS AND MAIN RESULTS

Oral dextran sulfate was given without significant side effects. The commonest minor subjective complications were mental hyperexcitability and gastrointestinal complaints. The most frequent laboratory abnormalities were leukopenia and hepatic transaminase elevations. Eleven patients required dose reductions, and therapy was stopped in 4 because of toxicities. The CD4 lymphocyte numbers did not change appreciably. No decline in beta-2 microglobulin levels occurred. The HIV antigen levels were unchanged from baseline. No assay for dextran sulfate plasma levels has yet proven successful.

CONCLUSIONS

Oral dextran sulfate appears to be well tolerated. No evidence of systemic absorption of the parent compound is available. However, in view of the promising in vitro effects and acceptable toxicity, oral dextran sulfate as a potential antiretroviral agent continues to be studied.

Alterations of life span in the nematode Caenorhabditis elegans under monoxenic culture conditions

The nematode Caenorhabditis elegans was cultured monoxenically with E. coli as a food source and the influence of the bacterial growth conditions on the life span was studied. When bacterial growth was restricted by reducing the concentration of bactopeptone, which was supplied as the energy source in nematode growth medium (NGM), the nematode's life span tended to be prolonged without a marked effect on postembryonic development. The effect of bactopeptone on the life span was clearly observed during the postreproductive period (that is, after the egg-laying stage of the wild-type C. elegans) rather than during the larval to young adult stage. Evidence is presented that this alteration of the life span was not brought about by any factor in the bactopeptone but by the concentration of bacteria.

Relationship between MR relaxation time and muscle fiber composition

The relationship between magnetic resonance (MR) relaxation times and muscle fiber composition was investigated in 16 men, and a high positive correlation was found. Higher proportions of fast-twitch fiber were associated with longer relaxation times, indicating that fast-twitch fiber has a longer relaxation time than slow-twitch fiber. Multiple regression analysis, conducted to investigate the suitability of relaxation time as a model of estimating muscle fiber composition, revealed that T1 and T2 were significantly related to muscle fiber composition. These results indicate that MR relaxation time may be used to estimate muscle fiber composition.

Immunohistochemical evaluation of the neurotoxic effects of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) on dopaminergic nigrostriatal neurons of young adult mice using dopamine and tyrosine hydroxylase antibodies

The recovery of dopamine (DA) neurons in young adult mice from 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) damage was analyzed at various times after MPTP treatment with DA and tyrosine hydroxylase (TH) immunohistochemistry and also by chemical DA assay. A remarkable discrepancy in the recovery rate of DA and TH reactivities of the nigral neurons was observed: the TH immunoreactivities of both cell bodies in the substantia nigra and terminals in the neostriatum were markedly reduced 4 days after MPTP. However, these reactivities progressively improved and almost fully recovered after 25 days, while the DA immunoreactivities were maximally depleted 10 days after, and the depletion continued even through the 25th day. The alteration of DA levels was correlated with that of DA immunoreactivity. These findings suggest that a major effect of MPTP on the DA neurons of young adult mice is a transient neurotoxicity, and that the TH content improves more promptly than that of DA.

Dextran sulfate suppression of viruses in the HIV family: inhibition of virion binding to CD4+ cells

The first step in the infection of human T lymphocytes by human immunodeficiency virus type 1 (HIV-1) is attachment to the target cell receptor, the CD4 antigen. This step may be vulnerable to attack by antibodies, chemicals, or small peptides. Dextran sulfate (molecular weight approximately 8000), which has been given to patients as an anticoagulant or antilipemic agent for more than two decades, was found to block the binding of virions to various target T lymphocytes, inhibit syncytia formation, and exert a potent inhibitory effect against HIV-1 in vitro at concentrations that may be clinically attainable in human beings. This drug also suppressed the replication of HIV-2 in vitro. These observations could have theoretical and clinical implications in the strategy to develop drugs against HIV types 1 and 2.

Detection of antibodies against wheat germ agglutinin bound glycoproteins on the islet-cell membrane

An attempt was made to detect islet cell surface antibodies (ICSAb) using solubilized islet-cell glycoproteins as antigens. Isolated rat islets were labelled with 125I-wheat germ agglutinin (WGA) and solubilized by Nonidet P-40 with sonication. 125I-WGA-bound islet-cell proteins were incubated with test sera, and bound antibodies were precipitated with anti-human IgG or IgM immunobeads. Serum which had a bound percent beyond the mean plus 2SD of control sera was defined as antibody-positive. Results obtained by this method correlated well with those by the immunofluorescence method of detecting ICSAb. Prevalences of antibodies were 21/114 (18%) for IgG antibodies and 9/114 (8%) for IgM antibodies in patients with insulin-dependent diabetes mellitus (IDDM). The prevalence was highest for both IgG and IgM antibodies in patients within a year of the onset of disease (38 and 25%, respectively), and decreased thereafter. The prevalence of IgM antibodies was lower than that of IgG antibodies at all stages. In NIDDM patients, the prevalence of antibodies was 5/72 (7%) for both IgG and IgM antibodies. If these preliminary results are confirmed, this radioassay may be developed to detect antibodies against islet cell membrane proteins on a large scale.

Mutations affecting acetylcholine levels in the nematode Caenorhabditis elegans

Gene cha-1.unc-17 of the nematode Caenorhabditis elegans is a complex gene, consisting of at least two complementation groups. One part (cha-1 region) of the gene encodes the enzyme choline acetyltransferase (ChAT), but the function of the other part (unc-17 region) is still unclear. We measured the ChAT activity and ACh levels of the cha-1 and unc-17 complex gene mutants. We show here that alterations in ACh levels, rather than the ChAT activity, reflect abnormal phenotypes accompanying cha-1.unc-17 mutations, that is, the decreased ACh levels in cha-1 mutations and abnormal accumulation in unc-17 mutations. Our results suggest that the unc-17 region may encode functions necessary for storage and/or release of ACh at the presynaptic level.

A case of Klinefelter's syndrome associated with hypothalamic-pituitary dysfunction caused by an intracranial germ cell tumor

A 17 year-old boy was admitted to the hospital because of thirst, polyuria (5-61/day), delayed sexual development and muscle weakness. He appeared obese, had an eunuchoidal body habitus and was excessively tall. Chromosomal analysis revealed a 47XXY karyotype. Serum cortisol was 1.3 microgram/dl, LH, 10.4 mIU/ml, FSH, 2.0 mIU/ml, and testosterone, 10 ng/dl. Endocrinological dynamic tests indicated diabetes insipidus and hypopituitarism of a hypothalamic type. Brain CT disclosed the existence of a tumor shadow around the calcified pineal body, extending towards the suprasellar region. Replacement therapy with glucocorticoid and DDAVP was started. The patient complained of a headache and plasma AFP and hCG concentrations were 868 ng/ml and 68.6 IU/ml respectively. A hCG- and AFP- producing germ cell tumor was suspected and radiation therapy with 60Co was performed. Plasma AFP and hCG were decreased with significant clinical improvement. Soon after irradiation, he started to complain of a headache and had elevated AFP and hCG levels. Right hemiparesis and unconsciousness suddenly appeared and he died of left thalamic bleeding. This is the first case of Klinefelter's syndrome associated with intracranial germ cell tumor. Plasma testosterone levels fluctuated in parallel with the change in plasma hCG levels. This shows that the Leydig cells in this patient could respond to some extent to tumor-producing hCG.

The polymorphism linked to the human insulin gene: its lack of association with either IDDM or NIDDM in Japanese

Polymorphism of 5' portion of the human insulin gene was examined in 188 unrelated Japanese subjects (49 normal, 71 with IDDM, and 68 with NIDDM) using restriction endonuclease analysis. Restriction fragments were classified according to the insertion size: Class 1 (600 base pairs), Class 2 (1300 base pairs), and Class 3 (2000 base pairs). We found a very high frequency of Class 1 alleles (96.8%) and a low frequency of both Class 2 (0.8%) and Class 3 alleles (2.4%) and that approximately 94% of the genotypes were Class 1/Class 1 homozygote. In addition, there was no correlation of allelic or genotypic frequency with NIDDM or IDDM. We conclude that length polymorphism of the human insulin gene cannot be a useful marker for diabetes in Japanese.

Prostaglandin E2, a seminal constituent, facilitates the replication of acquired immune deficiency syndrome virus in vitro

Acquired immune deficiency syndrome (AIDS)-associated virus is thought to be transmitted effectively through semen during sexual activities from male to male or from male to female. Prostaglandin (PG) E2 is one of the immunosuppressive compounds present in high concentrations in human semen. We, therefore, investigated direct effects of PGE2 and other PGs on AIDS-associated virus infection and replication in vitro. First, type III human T-lymphotropic virus (HTLV-III) was used to infect a T-cell line (MT-4) in culture. PGE2 (10 nM to 10 microM) added to the culture medium enhanced the production of infectious virus in a dose-dependent fashion. In the presence of 5 microM PGE2, 2.5-fold more virus were released from the infected MT-4 cells as compared to untreated control cells on day 3 after infection. Second, when we used an HTLV-III continuous-producer cell line (Molt-4/HTLV-III), PGE2 and PGD2 added to the culture medium increased the number of viruses released from Molt-4/HTLV-III cells. Other PGs such as PGF2 alpha and 13,14-dihydro-15-keto PGE2 did not affect the replication of HTLV-III in this system. These results indicate that some PGs including seminal PGs enhance the AIDS-associated virus replication in vitro. We propose that PGE2 in human semen might directly facilitate the infection of AIDS-associated virus and cause the efficient transmission of the virus during sexual activities.

Prostaglandin E2 administered via anus causes immunosuppression in male but not female rats: a possible pathogenesis of acquired immune deficiency syndrome in homosexual males

To explain a possible pathogenesis of acquired immune deficiency syndrome (AIDS) in homosexual males, we propose the following hypothesis. Prostaglandin E2 in human semen given via anus during anal intercourse may cause an immune dysregulation in the male semen recipients; this immunosuppressive effect of prostaglandin E2 may be one of the underlying factors that stimulate AIDS-associated virus infection or that trigger the latent AIDS-associated virus. This hypothesis is supported by the following experimental results. Anal infusion of prostaglandin E2 or D2 into male rats reduced in vitro responses of T lymphocytes to phytohemagglutinin. However, the T-cell response of female rats was not reduced significantly by the anal infusion of seminal prostaglandins.

Relationship between hypoglycemic symptoms and blood glucose levels due to self-monitoring in summer camp for diabetic children in Japan

In a summer camp for 47 diabetic children in Kinki district, Japan, in 1984, the relationship between hypoglycemic symptoms and blood glucose levels by self-monitoring was analyzed. During the 7-day camp, self-monitoring of blood glucose (SMBG) was carried out 599 times in total, 12.7 times per camper. SMBG due to hypoglycemic complaints amounted to 371. 154 measurements out of 371 indicated blood glucose levels under 80 mg/dl, but 78 monitorings were found to be over 200 mg/dl. Fatigue or weakness were the most frequent hypoglycemic symptoms, as was hunger sensation, each reaching approximately 40% in frequency. In most complaints of tremor, the blood glucose level was critically low. Prompt measurement of blood glucose is indeed necessary to properly treat diabetic children with 'hypoglycemic' symptoms.

Effect of TSH on conversion of T4 to T3 in perfused rat kidney

This study was undertaken to elucidate the effect of thyrotropin (TSH) on the conversion of thyroxine (T4) to 3,5,3'-triiodothyronine (T3) in the isolated perfused rat kidney. The kidney was perfused with a synthetic medium containing 20 micrograms/dL T4 and the effect of constant infusion of bovine TSH (125 or 250 microU/mL) on the conversion of T4 to T3 was investigated. T4 uptake in the perfused kidney was not changed by the addition of TSH. However, the release of T3 (89 +/- 11 ng/g/30 min, mean +/- SD), tissue T3 (190 +/- 23 ng/g/30 min), net T3 production (227 +/- 37 ng/g/30 min), and the conversion rate of T4 to T3 (9.5 +/- 1.6%) in the kidney perfused with 250 microU/mL TSH were significantly (P less than 0.005) greater than those in controls (63 +/- 9, 143 +/- 15, 152 +/- 36 ng/g/30 min, and 6.3 +/- 1.9%), respectively. Degradation rate of T3 in perfused rat kidney was not changed by the addition of 250 microU/mL TSH. These results suggest that TSH may directly affect renal iodothyronine-monodeiodinating activity in rats in vitro.

Temperature-sensitive mutations causing reversible paralysis in Caenorhabditis elegans

A method has been developed for the isolation of temperature-dependent paralytic mutants of the nematode Caenorhabditis elegans, based on a screening procedure using short-time exposure to 30 degrees C. Of ten mutants isolated, eight lose their motilities between 30 degrees C and 33 degrees C without prominent changes in body forms. The other two strains that are mainly described in this report are accompanied by alterations in body forms. One mutation, cn101, is recessive and an allele of cha-1. The cn101 mutant shows reversible paralysis at 30 degrees, accompanied by a hypercontracted and coiled body form. At the restrictive temperature, the strain is resistant to all tested inhibitors of acetylcholinesterase (AChE). Another mutation, designated mah-2 (cn110), is a sex-linked semidominant that is mapped as 0.6 map units left of dpy-6. The cn110 mutant is rapidly paralyzed at the restrictive temperature and has a straight and rigid body form; the mutant rapidly recovers when the temperature is lowered. No disorganization of the muscle structure was detected by polarized light and electron microscopic inspection.