[Evaluation of bone mineral turnover in children with nephrotic syndrome--the implications of original disease and the effects of corticosteroids on bone metabolism]

A long term corticosteroids (CS) treatment is often required for children with nephrotic syndrome (NS), which may affect their bone metabolism. In this study we evaluate the effects of CS, and also the implication of the character of NS itself on bones. We divided sixteen cases of idiopathic NS in children into two groups, such as CS responder group (R; male/female = 8/4, mean age 10.9 years old), and CS non-responder group (NR; male/female = 4/0, mean age 10.2 years old). We measured the bone mineral density of lumber vertebrae by quantitative computed tomography (QCT), some biochemical and endocrinological markers for about half a year. The bone mineral density was significantly decreased soon after the beginning of CS therapy. A significant decrease in the serum osteocalcin level and a slight tendency for an increase in urinary excretion of the free hydroxyproline in the both R and NR groups. In addition, NR group showed hypocalcemia, a decrease in the serum 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3, and a slight tendency for an increase in the C-parathyroid hormone and highly sensitive parathyroid hormone levels. In conclusion, the results suggested that the effects of CS on bone metabolism were mainly the suppression of bone formation. In addition, the effects of CS and the character of NS itself should be evaluated separately when we consider about bone metabolism in children with NS and in greater detail.

Formation of 18-deoxy-19-noraldosterone by a human aldosterone-producing adenoma

The recently synthesized 18-deoxy-19-noraldosterone is a potent aldosterone antagonist. In the present study we demonstrate the in vitro formation of 18-deoxy-19-noraldosterone from 19-noraldosterone in a human aldosterone-producing adenoma and normal adrenal tissue. The metabolite was isopolar, cochromatographed with the authentic standard on high-performance liquid chromatography, and the identity was further analyzed by mass spectrometry. The possible role of 18-deoxy-19-noraldosterone in primary aldosteronism is also discussed.

Hyperthermotherapy added to the multidisciplinary therapy for penile cancer

We performed a long-term follow-up of 4 patients with penile cancer who underwent hyperthermotherapy from August 1985 until August 1992. Hyperthermia was applied using a frequency of 350 MHz with a waveguide applicator twice a week for 60 min each for an average of 9.5 times (varying from 6 to 13 times). The total heating time that the temperature of urethra could be kept above 42 degrees C, was 166 min on the average (ranging from 0 to 463 min). Two patients classified as stage I according to the Jackson classification and 1 patient classified as stage IV underwent combined radiotherapy and received an average radiation dose of 53 Gy (range, 40-70 Gy). Among these patients 2 underwent combined chemotherapy with bleomycin or peplomycin. Malignant cells disappeared posttherapeutically and in August 1992, after an average of 5 years and 9 months (varying from 4 years 6 months to 6 years 10 months), the patients were free of recurrences. The one patient on stage IV had extensive invasion of the abdominal wall, but still recovered completely. One patient on stage III underwent combined chemotherapy and hyperthermotherapy, but heating had obviously been insufficient. There was a residue of malignant cells after the treatment and we performed a penectomy. Regarding functional preservation of the penis a multidisciplinary therapy incorporating hyperthermotherapy can be expected to increase the curativity. This indicates that it could induce in an advanced case, where an operation would be difficult, complete remission.

Novel water-soluble derivatives of docosahexaenoic acid increase diacylglycerol production mediated by phosphatidylcholine-specific phospholipase C

The effect of ascorbic acid 6-docosahexaenoate (DHA-VC) on the phospholipase-C-mediated hydrolysis of phosphatidylcholine was investigated. In human non-small cell lung cancer cells (PC-14) exposed to DHA-VC for 24 hr, a dose-dependent increase in phosphatidylcholine-specific phospholipase C (PC-PLC) activity was seen. PC-PLC activity in whole-cell homogenate of PC-14 cells was increased about 2.5-fold by 2 hr of treatment with DHA-VC (20 micrograms/ml). Treatment with DHA-VC also augmented PC-PLC activity in the crude membrane extract. On the other hand, DHA-VC inhibited the activity of phospholipase A2 (ID50 = 800 micrograms/ml). Another water-soluble analog, choline docosahexaenoate, also stimulated PC-PLC activity. To explore the effect of DHA-VC on phosphatidylcholine turnover, we analyzed phospholipids labeled with [14C] choline or [3H]myristate by thin-layer chromatography, and found that the amount of [14C]- and [3H]-labeled phosphatidylcholine was constant in the presence of DHA-VC. These results suggest that phosphatidylcholine turnover was not influenced by DHA-VC. DHA-VC treatment increased protein kinase C activity of the cells in the late phase (120 min), suggesting that DHA-VC-induced diacylglycerol production mediated by PC-PLC causes protein kinase C activation. Considering that significant inhibition of DNA synthesis occurred 12 hr after 2 hr of treatment with DHA-VC (20 micrograms/ml), DHA-VC-induced PC-PLC activation seems to be an early event in DHA-VC-induced cytotoxicity, which suggests that the effects of DHA-VC on signal transduction pathways may play an important role in the cytotoxicity of DHA-VC.

Rapid acceleration of neutrophil apoptosis by tumor necrosis factor-alpha

We demonstrate here that human necrosis factor-alpha, a potent neutrophil activator, induces rapid (within 3 h) apoptosis of these cells, i.e. neutrophils treated with this cytokine exhibit (i) light and electron microscopic changes characteristic to apoptotic cells, (ii) reduced propidium iodide binding to DNA, and (iii) the ladder form of DNA, as shown by agarose gel electrophoresis. These results suggest that apoptosis acceleration may be involved in processes by which neutrophils are prevented from damaging tissues.

Angiotensin I-converting enzyme inhibitory peptides derived from bonito bowels autolysate

Six angiotensin I-converting enzyme inhibitory peptides were isolated from a bonito bowels autolysate. Their amino acids were sequenced as Tyr-Arg-Pro-Tyr, Gly-His-Phe, Val-Arg-Pro, Ile-Lys-Pro, Leu-Arg-Pro, and Ile-Arg-Pro. Peptides having corresponding amino acid sequences were synthesized by a solid-phase method and their inhibition of the activity measured. IC50 of these peptides were estimated to be 320, 1100, 2.2, 2.5, 1.0, and 1.8 microM, respectively. The role of carboxyl terminal proline residues on the inhibition is discussed.

Albumin-binding superoxide dismutase with a prolonged half-life reduces reperfusion brain injury

To test the possible involvement of superoxide radicals in the pathogenesis of reperfusion injury, we synthesized a superoxide dismutase (SOD) derivative [poly(styrene-co-maleic acid) butyl ester (SM) covalently linked to SOD] that circulates bound to albumin, has a prolonged in vivo half-life, and accumulates in pH-decreased tissues. The protective effects of SM-SOD on regional cerebral blood flow, intracranial pressure, cardiac index, vascular permeability, and neurological outcome were investigated using a model of global brain ischemia in dogs. Intra-arterial injection of SM-SOD (10 mg/kg) just before reperfusion increased reactive hyperemia (SM-SOD, 160 +/- 36 ml.100 g-1.min-1, means +/- SD, n = 6; control, 100 +/- 34 ml.100 g-1.min-1, n = 6, P = 0.015), ameliorated delayed hypoperfusion (7 h after ischemia: SM-SOD, 40 +/- 14 ml.100 g-1.min-1; control 17 +/- 6 ml.100 g-1.min-1, P = 0.003), vascular permeability, and neurological outcome without affecting the cardiac index. These results indicate that superoxide radicals and/or their metabolite(s) might play a critical role in the pathogenesis of reperfusion injury in the brain.

Increased concentration of endothelin messenger RNA in the mesenteric arteries of cyclosporine-induced hypertensive rats

The aim of this study was to investigate the expression of endothelin-1 (ET-1) in the mesenteric arteries of cyclosporine-induced hypertensive rats. The concentration of plasma ET-1 and of mesenteric artery ET-1 messenger RNA was measured in cyclosporine-induced hypertensive and control rats. The concentration of ET-1 messenger RNA in the mesenteric arteries of cyclosporine-treated rats (25 mg/kg/day for 6 weeks) was significantly greater than in control rats (P < .05). We propose that cyclosporine-induced hypertension may be due to an increased synthesis of ET-1 in the resistant vessels.

Identification and characterization of heat-stable enterotoxin II-producing Escherichia coli from patients with diarrhea

Stock strains of Escherichia coli isolated from patients with traveller's diarrhea were examined for production of heat-stable enterotoxin II (STII). Of 400 strains examined, 3 were found to produce STII. The nucleotide sequence of the STII gene of these human strains was shown to be identical to that of porcine strains. Cultured cells of these strains induced fluid accumulation in ligated mouse intestinal loops and the activity was neutralized by anti-STII antiserum. These results suggest that STII-producing enterotoxigenic E. coli can cause human diarrhea.

Effects of MS-551, a new class III antiarrhythmic drug, on action potential and membrane currents in rabbit ventricular myocytes

1. Electrophysiological effects of MS-551, a new class III antiarrhythmic drug, were examined and compared with those of (+)-sotalol in rabbit ventricular cells. 2. In rabbit ventricular muscles stimulated at 1.0 Hz, MS-551 (0.1-10 microM) and (+)-sotalol (3-100 microM) prolonged action potential duration (APD) and effective refractory period without affecting the maximum upstroke velocity of phase 0 depolarization (Vmax). The class III effect of MS-551 was approximately 30 times more potent than that of (+)-sotalol. 3. Class III effects of MS-551 and (+)-sotalol showed reverse use-dependence, i.e., a greater prolongation of APD at a longer cycle length. 4. In rabbit isolated ventricular cells, 3 microM MS-551 and 100 microM sotalol inhibited the delayed rectifier potassium current (IK) which was activated at more positive potentials than -50 mV and saturated around +20 mV. 5. MS-551 at a higher concentration of 10 microM decreased the transient outward current (Ito) and the inward rectifier potassium current (IK1) although 100 microM sotalol failed to inhibit these currents. 6. MS-551 is a non-specific class III drug which can inhibit three voltage-gated K+ channels in rabbit ventricular cells.

Apoptosis of lung cancer cells caused by some anti-cancer agents (MMC, CPT-11, ADM) is inhibited by bcl-2

To determine whether the apoptotic cell death induced by anti-cancer agents could be inhibited by bcl-2, we established a bcl-2-transfected human small cell lung cancer cell line, SBC-3/Bcl2. SBC-3/Bcl2 showed higher resistance to ADM, CPT-11 and MMC compared with the parental line SBC-3, with relative resistance values of 3.4, 7.6 and 5.7, respectively. However, there was no difference in sensitivity to CDDP, VP-16, ACNU, MTX and taxol between SBC-3 and SBC-3/Bcl2. Agarose gel electrophoresis showed typical DNA fragmentation of SBC-3 following treatment with CPT-11 or MMC, in a concentration-dependent manner. In contrast, the same concentration of the drugs did not induce DNA fragmentation in SBC-3/Bcl2. Treatment with CDDP resulted in the same degree of DNA fragmentation in SBC-3 and SBC-3/Bcl2. These studies indicate that bcl-2 can modulate the cytotoxicity of some anti-cancer agents by inhibiting the process of apoptosis.

Endoscopic evaluation of the depth of invasion of the depressed type early gastric cancer and apparently early advanced cancer in cases of a peptic ulcer within the cancer lesion

Depressed-type early and apparently early advanced cancers were divided into two groups according to whether or not an associated peptic ulcer was present within the cancer lesion, and the accuracy of preoperative endoscopic diagnosis was reviewed. As a result it was found that evaluation of depth of invasion was more difficult in the ulcer [UL(+)] group than in the group without an ulcer [UL(-)]. In the UL(+) group it was difficult to identify endoscopic findings which indicate depth of invasion at the tip of the folds, the volume of cancer invasion of the deeper layers was small, and there many cases of invasion of deeper layers in a portion of the margins of the peptic ulcers.

Multivariate analysis of magnetic resonance imaging of focal hepatic lesions

A total of 124 lesions from 1 to 6cm in diameter, including 31 cavernous hemangiomas, 32 metastases and 61 hepatocellular carcinomas (HCC) were analyzed to study the usefulness of magnetic resonance imaging (MRI) at 0.5 Tesla to differentiate focal hepatic lesions on the basis of qualitative criteria. Each focal hepatic lesion was assessed for shape, internal architecture and signal intensity relative to normal liver parenchyma. While all cavernous hemangiomas and metastases except one lesion could be detected, detection rate of HCC was significantly inferior to that of the other two diseases. A tumor capsule and a hyperintense focus on T1-weighted images were demonstrated in only HCC lesions in strong contrast with the other two diseases; however, metastases with slow-growing characteristics or subacute hematoma may appear as similar images. Cavernous hemangiomas appeared markedly hyperintense on T2-weighted images in 23 of 31 lesions, but one metastasis and one HCC had similar images. A multivariate analysis of several MRI resulted in the following mean discriminant scores: cavernous hemangioma, -1.2652; metastasis, 0.1830; and HCC, 0.7138. It appeared to be possible to differentiate the three diseases with 84.4 percent accuracy.

Effects of growth hormone on follicle growth, oocyte maturation, and ovarian steroidogenesis

OBJECTIVES

To assess the effects of GH on follicle growth, oocyte maturation, ovulation, and ovarian steroidogenesis.

DESIGN

In vitro perfused rabbit ovary.

INTERVENTIONS

The rabbit ovaries were perfused with medium alone, with GH at 1, 10, 100, or 200 ng/mL, or with 50 IU hCG for 12 hours.

MAIN OUTCOME MEASURES

The follicle diameter, the percent change in follicle diameter, the percentage of oocytes achieving germinal vesicle breakdown, and the production of P and E2 by the perfused rabbit ovaries.

RESULTS

The addition of GH to the perfusate increased the follicle diameter at 12 hours after perfusion in a dose-dependent manner. The percent change in follicle diameter in GH-treated ovaries did not differ significantly from that in hCG-treated ovaries at each time point of perfusion. However, ovulation did not occur in either the control ovaries or the experimental ovaries treated with GH. Exposure to GH at a concentration of > 10 ng/mL significantly stimulated the resumption of meiosis, as compared with the contralateral control ovaries. Although the concentration of P in the perfusate did not differ significantly between GH-treated and control ovaries, GH stimulated E2 production by the perfused rabbit ovaries in a dose-dependent manner.

CONCLUSIONS

Growth hormone acts on the rabbit ovary to stimulate follicle growth, oocyte maturation, and ovarian E2 production.

[Incidence and prevalence of serotypes of enteroaggregative Escherichia coli from diarrheal patients in Brazil, Myanmar and Japan]

By using HeLa cells, we tried to detect enteroaggregative Escherichia coli from stock strains derived from infants with or without diarrhea in Brazil and Myanmer, and from diarrheal patients in Osaka, Japan. Enteroaggregative E. coli was detected from 7.9% in diarrheal cases, 5.6% in control cases in Brazil and from 5.4% in diarrheal cases, 3.4% in control cases in Myanmar. A total of 38 strains that showed aggregative adherence to HeLa cells was examined for colony hybridization with the 32P-labeled EAggEC probe. Thirty-four strains hybridized with the EAggEC probe, while 4 strains did not hybridize with the probe, suggesting an existence of another aggregative factor. Seventeen of the 38 strains were O-antigen serotypeable. Eight strains belonged to serogroups O44, O86, O111, O125 and O126, which have been considered to be enteropathogenic E. coli serogroups. Most of the 38 strains were H-antigen serotypeable.

Cyclosporine A induces endothelin-1 release from cultured rat vascular smooth muscle cells

Since vascular smooth muscle cells in culture are capable of secreting endothelin-1 (ET-1), we investigated the effect of cyclosporine A on ET-1 release from rat vascular smooth muscle cells. Cyclosporine A 10 microM significantly (P < 0.05) enhanced the secretion of ET-1 at 2, 8, 24 and 48 h (6.5 +/- 0.5, 11 +/- 0.7, 19 +/- 0.5, 37 +/- 1.6 fmol/10(6) cells, respectively) compared with vehicle (4.7 +/- 0.3, 8.1 +/- 0.6, 15 +/- 0.4, 27 +/- 2.0 fmol/10(6) cells, respectively). The cyclosporine-induced synthesis of ET-1 by vascular smooth muscle cell may participate in the pathogenesis of cyclosporine-induced vasoconstriction and vasculopathy via an autocrine regulatory mechanism.

Inhibitory effects of insulin-like growth factor (IGF)-binding proteins-1 and -3 on IGF-activated glucose consumption in mouse BALB/c 3T3 fibroblasts

We have examined the biological effects of insulin-like growth factor-binding proteins (IGFBPs) on insulin-like growth factor (IGF)-activated glucose consumption in a BALB/c 3T3 subline. The method employed was a colorimetric measurement of glucose consumption, allowing the detection of changes from the initial glucose concentration in conditioned medium, following the addition of IGFs and IGFBPs. Human IGFBP-1, purified from amniotic fluid, inhibited IGF-activated glucose consumption, although it had no effect on insulin-activated glucose consumption. The median effective dose (ED50) of IGFBP-1 to cause inhibitory effects on IGF-activated glucose consumption was 100-200 micrograms/l and was similar for both IGF-I and IGF-II at a concentration of 1.0 microgram IGF/l. Therefore, at IGF concentrations of comparable activity, the inhibitory effects of IGFBP-1 were greater for IGF-I than for IGF-II, because of the higher activity of IGF-I in this assay. Recombinant human IGFBP-3 also inhibited IGF-activated glucose consumption, without affecting insulin-stimulated glucose consumption. The inhibitory effects of IGFBP-3 were greater for IGF-II than for IGF-I when IGFBP-3 was coincubated with either of the IGFs, at both IGF concentrations of comparable activity and equivalent molar concentrations. Thus, it became clear that the inhibitory effects of these IGFBPs on IGF biological action depended primarily upon their affinity for the specific IGF ligand and molar ratio of IGFBP/IGF peptide. Interestingly, when cells were pretreated with IGFBP-3, prior to the simultaneous addition of IGFs and IGFBP-3, the inhibitory effect was higher for IGF-I than for IGF-II. Either no effect or a minor inhibitory effect on IGF-activated glucose consumption was detected with IGFBP pretreatment alone. When the ED50 for inhibition of IGF action by IGFBPs in this in-vitro assay was compared with the physiological concentrations of IGFs and IGFBPs in normal human serum and in amniotic fluid, it was estimated that the IGFBP-1 concentration present in serum was not sufficient to modulate IGF action effectively while the concentration in amniotic fluid was enough for effective suppression. IGFBP-3 exhibited an ED50 low enough to suppress IGF-II and possibly IGF-I action when cells were pretreated with IGFBP-3. Thus, our data suggested that IGFBP-1 in amniotic fluid and IGFBP-3 in serum could be a potent inhibitor for IGF action. IGFBP-1 in serum, however, may not be able to function as a direct inhibitor under physiological conditions but, rather, may modulate IGF action together with other IGFBPs.

Aminoalkylbisphosphonates, potent inhibitors of bone resorption, induce a prolonged stimulation of histamine synthesis and increase macrophages, granulocytes, and osteoclasts in vivo

Aminoalkyl derivatives of bisphosphonates are potent inhibitors of bone resorption. A single I.P. injection of 4-amino-1-hydroxybutylidene-1,1-bis-phosphonate (AHBuBP) induced a prolonged enhancement of histidine decarboxylase (HDC) activity in the bone marrow, spleen, lung, and liver of mice and resulted in an increase in histamine. The induction of HDC by the agent was dose dependent (16-80 mumol/kg) and peaked 3-4 days after its injection (40 mumol/kg). Repeated S.C. injections of smaller doses of AHBuBP (0.32 or 1.6 mumol/kg/day) for 4 days also enhanced HDC activity. However, the minimum dose capable of inhibiting bone resorption (0.064 mumol/kg/day) was lower than that inducing HDC. Unexpectedly, AHBuBP, at the doses inducing HDC, increased macrophages, granulocytes, and even osteoclasts. The size of osteoclasts was also enlarged by the agent. Another aminobisphosphonate, 3-amino-1-hydroxypropylidene-1,1-bisphosphonate, but none of non-amino derivatives, also exhibited essentially the same effects as those of AHBuBP. These results indicate that in spite of increase in osteoclasts and their enlargement, bone resorption is still inhibited by amino bisphosphonates. As granulocyte and granulocyte-macrophage colony-stimulating factors and interleukin-3 induce HDC in hematopoietic organs, and histamine has a hematopoietic activity, the HDC induction by aminobisphosphonates may be relevant to the proliferation of progenitor cells of macrophages, granulocytes, and osteoclasts.

[Clinical assessment of meningeal carcinomatosis; from the viewpoint of the analysis of intracranial pressure]

Meningeal carcinomatoses (MC) have been mainly studied from the viewpoint of the analysis of intracranial pressure (ICP). From the CT findings, ten patients were divided into two groups: group I, six patients showed characteristics of MC; group II, four showed normal characteristics. Ventricular fluid pressure (VFP) was continuously measured by a controlled ventricular drainage tube using a Spectramed P-10EZ at 3.1 +/- 2.1 months after the onset of the neurological symptoms. At the same time as VFP monitoring, the CBF by 133Xe method was measured in 5 cases and RI cisternography was performed in 9 cases. "A" wave was observed in 5 cases of group I and in 3 cases of group II. "B" wave was observed in all cases of both groups. In all 10 cases, the occurrence rate of both A and B waves (ORA, ORB) were high, averaging 2.34 +/- 0.54 times/hour, 74.0 +/- 16.6% time, respectively. Mean resting pressure(R) and mean peak pressure(P) tended to be high, averaging 28.8 +/- 12.2mmHg, 58.9 +/- 13.7mmHg, respectively. Mean cerebral perfusion pressure corresponding with R and P (CPPR, CPPP) was markedly reduced, averaging 79.1 +/- 15.9mmHg, 50.9 +/- 12.7mmHg, respectively. Both ORA and ORB in group I were higher, and both CPPR and CPPP in group 1 were lower, than in group II. Statistically, this is significant. Both R and P in Group I tended to be higher than in group II. This has no statistical significance. CBF in all 5 cases averaged 34.8 +/- 8.4ml/100g/min. No significant difference in the impairment of CBF was found between both groups. RI cisternography showed delayed clearance in all 9 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Role of growth factors on fetal growth and maturation

Several growth factors have been demonstrated to be involved in fetal growth. In this study, physiological significance of two growth factors, epidermal growth factor (EGF) and insulin-like growth factor-I (IGF-I) on fetal growth was evaluated. IGF-I stimulated 3H-glycine uptake by cultured trophoblast cells from term pregnancy while EGF did not stimulate it. A large part of IGF-I was associated with its binding proteins (IGFBPs) in the circulation and one of IGFBPs, IGFBP-1 inhibited 3H-glycine uptake by IGF-I in a dose dependent manner. IGF-I also stimulated 3H-aminoisobutyric acid (3H-AIB) release by trophoblast cells when cells were saturated with 3H-AIB first, then stimulated with IGF-I. In animal experiments, placental weight but not fetal weight was suppressed when EGF antiserum was administrated to maternal mice, however, fetal lung maturity in terms of lamella body produced in type II alveolar cells was suppressed in antiserum given group. When anti IGF-I antiserum was administrated to pregnant mice, both fetal and placental weight were significantly suppressed and transfer of 3H-AIB to fetus was also suppressed. In contrast, antiserum to IGFBP-1 stimulated fetal growth and transfer of 3H-AIB to fetus. Furthermore, fetal lung on Day 17 in anti IGFBP-1 antiserum administrated mice showed morphologically advanced changes that were equivalent to Day 18 or 19 of control. These results indicate that EGF and IGF-I regulate fetal growth and maturation independently and that IGF-I and IGFBP-1 influence fetal development in a counter regulatory system.

[A case of cortical deafness with bilateral putaminal hemorrhage]

A 56 years old right-handed female, a housewife, had suffered from right putaminal hemorrhage which had been treated surgically in July, 1985. Since it was difficult to approach the trans-sylvian fissure, evacuation of the hematoma was performed transcortically through the superior temporal gyrus. She was neurologically free and lived normally until she suddenly became completely deaf in April, 1991. On admission, she was alert, well oriented and spontaneously stated that she was deaf. She showed no response to verbal commands or loud noises but followed complex written commands. No other neurological deficit was observed. In addition to an irregular low-density area in the right temporal lobe, CT scan revealed a left putaminal hemorrhage. Audiological testing disclosed pure tone thresholds to be below 90db on both sides. Auditory brain stem response (ABR) showed waves I to VI in normal latency ranges, but wave VII was not observed. She was treated conservatively. Although her hearing loss had been gradually improving for 1 month, she suffered from word deafness, an inability to comprehend speech, for the following 2 months. Clinical features, CT findings as well as results of ABR suggest that hearing loss observed in this case, cortical deafness, was presumably due to bilateral damage of acoustic radiation of the temporal lobe. It was also suggested that, although she was asymptomatic, cortical and subcortical damage to the right temporal lobe following evacuation of the putaminal hematoma may have been extensive. During surgical procedures for evacuation of the putaminal hematoma, it has to be always kept in mind not to damage the auditory cortex and its radiations.