Diagnosis of Toxoplasma meningoencephalitis in a non-AIDS patient using PCR

We report herein a rare case of Toxoplasma gondii meningoencephalitis in a non-AIDS patient. Although T. gondii itself was not detected in nucleated cells in peripheral blood and cerebrospinal fluid under the microscope, the polymerase chain reaction method effectively detected the B1 gene of T. gondii in the cells. A serological examination showed increased levels of the IgG but not the IgM antibody to T. gondii, suggesting reactivation of the infection in the brain.

Histological remodeling in an ovine heart failure model resembles human ischemic cardiomyopathy

Staged coronary embolization, causing myocardial microinfarctions, has been shown in dogs and sheep to cause chronic ischemic heart failure (HF) that resembles the hemodynamics of the human condition. However, its histopathological basis remains unclear. We examined the hypothesis that the ventricular remodeling seen in such sheep resembles the histopathology of human ischemic cardiomyopathy (ICM). Understanding the pathophysiology of this model will determine its place in the development of treatment strategies for HF. Global left ventricular (LV) damage resulting in HF was induced by staged coronary embolization in 11 sheep. Six others served as controls (normal control, NC). In HF sheep, the heart was harvested 6 months after LV ejection fraction (EF) had stabilized at <35%. Histopathological profiles were compared in biventricular transverse sections at midpapillary level using computed image analysis. LV end-diastolic volume increased in the HF group from 84.9+/-29 to 122.4+/-30.3 ml (n=11, P<.05), but myocytes across the LV wall in noninfarcted zones decreased (435.7+/-38.2 NC; 297.8+/-48.4/unit area HF; n=11, P<.0001) as did myocyte nuclear density (990.5+/-51.5 NC; 677.5+/-121.1/mm(2) HF, n=11, P<.0001). In contrast, LV replacement and interstitial fibrosis increased as did myocyte diameter in noninfarcted zones: 0.1+/-0.1 to 6.2+/-4.5% (P=.0049); 2.0+/-1.0 to 7.6+/-4.9% (P=.0149); and 10.0+/-0.5 to 15.9+/-2.2 microm (P<.0001), respectively. Although LV myocyte nuclear length increased (10.2+/-1.0 NC; 12.2+/-0.9 microm HF, n=11, P=.0006), right ventricular (RV) myocyte nuclear density and length did not alter. In this ovine chronic HF model, LV dilation and interstitial and myocyte remodeling resemble human ICM.

Quantitative EEG data and comprehensive ADL (Activities of Daily Living) evaluation of stroke survivors residing in the community

The purpose of this study was to investigate the hypothesis that EEG values match other comprehensive activities of daily living (ADL) evaluations between stroke survivors and normal controls. Various functions related to ADL were examined by means of ADL assessments (Measurement of Competence in the Elderly Living at Home, Barthel Index, Stroke Impairment Assessment Set, time needed to walk 10 metres) and biosocial synchronization (the questionnaire on biosocial rhythms of daily living). EEG was undertaken using a computer-assisted portable EEG recorder. The power spectra were computed using a fast Fourier transformation analysis (FFT). The absolute and relative powers (percent of the total EEG power) of 5 frequency bands (delta, theta, alpha 1, alpha 2 and beta) and the peak frequency were analyzed. In comparing stroke survivors and the independent elderly, the latter had higher scores than the former in assessments of various functions related to ADL. The absolute and relative power of the delta band were lower in normal controls, and the relative power of the alpha (2) band and the peak frequency were higher than those of stroke survivors. Among the correlations between EEG and ADL assessments, the absolute and relative power of the alpha (2) band correlated significantly with ADL assessments of stroke survivors with right hemiplegia. The peak frequency was significantly increased in cases with high ADL scores. In conclusion, significant correlations were identified between the quantitative EEG data of stroke survivors in the chronic stage, living in the community, and ADL-related functions. Computer-assisted portable EEG recording is a potentially useful screening tool for objectively evaluating the functional levels of stroke survivors in field work.

Circadian rhythm abnormalities of wrist activity of institutionalized dependent elderly persons with dementia

BACKGROUND

The study objective was to clarify the descriptive characteristics of circadian rhythm abnormalities of wrist activity of the institutionalized elderly with dementia.

METHODS

We studied 82 elderly persons with dementia who were institutionalized in a long-term medical care facility. The ambulatory continuous monitoring of their wrist activity was conducted for 7 days at 1-minute intervals. The time series data were analyzed using the double-plotted chronogram, spectral analysis was performed using the fast Fourier transformation and periodogram analysis was performed as well.

RESULTS

The frequency of circadian rhythm abnormalities of wrist activity rhythm in elderly persons with dementia was 57.3% (47 out of 82). The abnormalities were classified into four categories: severely impaired circadian rhythm type with no boundary between day and night, free-running rhythm type, decreased circadian amplitude type, and accentuation of ultradian rhythm type.

CONCLUSION

This four-category classification system provides a scientific approach for studying the mechanisms of circadian activity rhythm abnormalities of elderly persons with dementia.

Ventricular remodeling after cardiomyoplasty in heart failure sheep: passive and dynamic effects

BACKGROUND

Recent reports claim that cardiomyoplasty (CMP) has a girdling effect on the left ventricle, to prevent dilatation and functional deterioration, but the mechanism of its long-term effects on the native heart is not known. We compared the relative role of CMP's active squeezing and passive girdling in chronically failing hearts.

METHODS

After induction of stable heart failure (left ventricular ejection fraction = 27% +/- 7%) by staged coronary microembolization, CMP was performed in 11 of 18 sheep. After 8 weeks pacing training of the latissimus dorsi muscle (LDM), cardiac assist was begun with 1:2 synchronous bursts in 6 sheep (d-CMP, n = 6), and the LDM in the passive group (p-CMP, n = 5) remained unstimulated. Four (base line) and 30 weeks after induction of heart failure, the pressure-volume relationship was derived.

RESULTS

After 30 weeks in d-CMP the slope (Emax) of the end-systolic pressure-volume relationship increased by 66% +/- 55% (p < 0.05) and external work efficiency by 48% +/- 41% (p < 0.01). In the passive CMP and control groups, slope and external work efficiency were unchanged. Conversely, left ventricular end-diastolic volume decreased (-14% +/- 12%, p < 0.05) in the dynamic CMP group compared with a static course in the passive CMP group (3% +/- 10%, p > 0.05) and an increase (18% +/- 15%, p < 0.05) in controls.

CONCLUSIONS

Dynamic CMP improved native heart's contractility and external work efficiency. In addition, whereas passive CMP has simply a girdling effect, dynamic CMP also induces reverse left ventricular chamber remodeling.

Potassium-adsorption filter for RBC transfusion: a phase III clinical trial

BACKGROUND

Within the past 2 years, three cases of cardiac arrest just after rapid transfusion of RBCs preserved for over 7 days after 15-Gy irradiation were found. This severe complication caused transient hyperkalemia. To prevent potassium (K(+)) overload by RBC transfusion at the bedside, a K(+)-adsorption filter made of sodium polystyrene sulfonate was developed.

STUDY DESIGN AND METHODS

After in vitro and animal safety and efficacy tests, a Phase III clinical trial was conducted with 65 patients given transfusions via the newly developed filter (filter group) and 37 patients in whom the filter was not used (control group) and transfusions were given at twice the usual flow rate (20 mL/min).

RESULTS

More than 85-percent (94.4+/-3.8%) removal of K(+) in RBCs in mannitol-adenine-phosphate (MAP) that had been preserved for more than 14 days or that were used 3 days after 15-Gy irradiation (calculated K(+): 3.8+/-1.3 mEq/bag) was achieved in 82 of 83 bags of MAP RBCs in the filter group, with 79.6 percent removed in the other, even in rapid transfusions. RBC recovery 1 day after transfusion, determined by increments in RBCs, Hb, and Hct, were 24 and 0.4 x 10(4) per microL, 0.7 and 0.3 g per dL, and 1.6 and 0 percent, respectively, in the filter and control groups. No adverse transfusion reactions, such as hypotension, anaphylactoid reactions, or asthma-like attacks, were observed, except for one case of urticaria in the filter group. Mild fever (within 1 degrees C) after transfusion was observed in both groups. Serologic markers of hemolysis rose slightly in both groups, but there was no significant difference between the two groups.

CONCLUSION

The newly developed K(+)-adsorption filter is useful, especially in a rapid transfusion setting.

[Renal cell carcinoma in acquired cystic disease of the kidney manifested by spontaneous renal hemorrhage]

Acquired cystic disease of the kidney (ACDK) is a common phenomenon in long-term adult dialysis patients with end-stage renal disease. Renal hemorrhage and neoplastic transformation of the cyst are two major complications of this entity and these two can occur independently. Here we describe a 65-year-old man with a history of hemodialysis-dependent end-stage renal failure for 12 years presented with macroscopic hematuria and right flank pain. Investigations revealed right massive perirenal and subcapsular hematoma with ACDK. The hemorrhagic state required nephrectomy of the right kidney. Histological study showed ACDK with massive subcapsular and perinephric hematoma containing minimal clear cell carcinoma region(0.5 cm in diameter). Although a causal relationship between renal hemorrhage and renal cell carcinoma in this patient was unproven, the present case suggests radical surgery can be a recommendable treatment modality of hemorrhagic ACDK.

Various abiotic stresses rapidly activate Arabidopsis MAP kinases ATMPK4 and ATMPK6

Mitogen-activated protein kinase (MAP kinase, MAPK) cascades play pivotal roles in signal transduction of extracellular stimuli, such as environmental stresses and growth regulators, in various organisms. Arabidopsis thaliana MAP kinases constitute a gene family, but stimulatory signals for each MAP kinase have not been elucidated. Here we show that environmental stresses such as low temperature, low humidity, hyper-osmolarity, touch and wounding induce rapid and transient activation of the Arabidopsis MAP kinases ATMPK4 and ATMPK6. Activation of ATMPK4 and ATMPK6 was associated with tyrosine phosphorylation but not with the amounts of mRNA or protein. Kinetics during activation differ between these two MAP kinases. These results suggest that ATMPK4 and ATMPK6 are involved in distinct signal transduction pathways responding to these environmental stresses.

Effects of capsaicin-containing yellow curry sauce on sympathetic nervous system activity and diet-induced thermogenesis in lean and obese young women

The present study was designed to investigate the effect of capsaicin, a pungent component of red pepper, on the sympathetic nervous system (SNS) activity and energy metabolism in 16 age- and height-matched lean and obese young women. The sympatho-vagal activities were assessed by means of spectral analysis of heart rate variability (HRV) during the resting condition and after the meal (2,016 kJ) with capsaicin (3 mg). Energy expenditure was also measured under the two conditions. There was no significant difference in any of the parameters of the HRV between the obese and control groups at rest. After the capsaicin diet, however, the very low frequency component (0.007-0.035 Hz) associated with thermogenesis (315.8+/-78.0 vs. 814.8+/-211.7 ms2 x Hz(-1), p<0.05) as well as its responsiveness (delta changes: 14.6+/-104.4 vs. 369.2+/-121.7 ms2 x Hz(-1), p<0.05) were significantly lower in the obese than the control group. Energy expenditure was significantly increased in the control group after the meal (5,574.7+/-221.2 to 6,114.7+/-239.0 kJ day(-1); p<0.01), but no such significant thermogenic response was detected in the obese group despite nearly identical lean body mass of the control group. Our data indicate that regardless of the resting level of sympatho-vagal activities, the reduced sympathetic responsiveness to physiological perturbation such as a capsaicin diet, which may cause impaired diet-induced thermogenesis and further weight gain, could be an important etiological factor leading to obesity in young women.

Characterization of fission yeast cohesin: essential anaphase proteolysis of Rad21 phosphorylated in the S phase

Cohesin complex acts in the formation and maintenance of sister chromatid cohesion during and after S phase. Budding yeast Scc1p/Mcd1p, an essential subunit, is cleaved and dissociates from chromosomes in anaphase, leading to sister chromatid separation. Most cohesin in higher eukaryotes, in contrast, is dissociated from chromosomes well before anaphase. The universal role of cohesin during anaphase thus remains to be determined. We report here initial characterization of four putative cohesin subunits, Psm1, Psm3, Rad21, and Psc3, in fission yeast. They are essential for sister chromatid cohesion. Immunoprecipitation demonstrates stable complex formation of Rad21 with Psm1 and Psm3 but not with Psc3. Chromatin immunoprecipitation shows that cohesin subunits are enriched in broad centromere regions and that the level of centromere-associated Rad21 did not change from metaphase to anaphase, very different from budding yeast. In contrast, Rad21 containing similar cleavage sites to those of Scc1p/Mcd1p is cleaved specifically in anaphase. This cleavage is essential, although the amount of cleaved product is very small (<5%). Mis4, another sister chromatid cohesion protein, plays an essential role for loading Rad21 on chromatin. A simple model is presented to explain the specific behavior of fission yeast cohesin and why only a tiny fraction of Rad21 is sufficient to be cleaved for normal anaphase.

Reliability and validity of the questionnaire to determine the biosocial rhythms of daily living in the disabled elderly

The questionnaire to determine the biosocial rhythms of daily living in the disabled elderly was newly developed. This questionnaire was aimed to evaluate a state of synchronization of biological rhythms in the disabled elderly. Eighteen items of the questionnaire relating to the synchronization of biological rhythms were finally selected by the test-retest method that was conducted for 68 disabled elderly living in a community with a duration of one year. The factor analysis showed that the questionnaire consisted of five factors: outdoor activities, ultradian rhythms, subjective evaluation of health status, social support, and sleep habits. The cumulative contribution rate of five factors was 53.2%. Reliability of the questionnaire was confirmed by a calculation of the Equal-length Spearman-Brown coefficients ranging from 0.60 to 0.80. Regarding the construct validity of the questionnaire, results of factor analysis showed five factors that were consistent with the synchronizers known in chronobiology. The total score of the questionnaire was significantly correlated to Barthel Index score and the competence score, suggesting that it partly reflects the activities of daily living of the disabled elderly. We conclude that a new questionnaire to determine the biosocial rhythm of daily living in the disabled elderly is useful to evaluate the biosocial synchronization of the disabled elderly because of its high reliability and validity.

Stimulatory function of gp49A, a murine Ig-like receptor, in rat basophilic leukemia cells

Murine gp49, a 49-kDa type I transmembrane glycoprotein, is a member of the Ig-like receptors expressed on the surface of cells involved in natural immunity such as mast cells, NK cells, and macrophages. The two major subtypes, gp49A and gp49B, are encoded by two different genes adjacent to each other. gp49B contains an immunoreceptor tyrosine-based inhibitory motif in its cytoplasmic region and is known to function as an inhibitory molecule. In contrast, gp49A does not harbor any specific motif for signal transduction, nor has its physiological role been determined. Here we report on the stimulatory nature of gp49A by analyzing biochemical characteristics of chimeric molecules consisting of an ectodomain of Fc receptor and a C-terminal half of gp49A, namely the pretransmembrane, transmembrane, and cytoplasmic portions, expressed on the rat basophilic leukemia mast cell line. Cross-linking of the chimeric receptors evoked cytoplasmic calcium mobilization, PGD(2) release, and transcription of IL-3 and IL-4 genes, but did not elicit degranulation of the cells. The chimeric molecule could be expressed as a singlet and a homodimeric form on the cell surface. A pretransmembrane cysteine residue of gp49A was necessary for dimer formation. Dimerization was be necessary for their incorporation into glycolipid-enriched membrane fraction (GEM) upon cross-linking stimuli. The calcium mobilization response was inhibited by treatment of cells with methyl-beta-cyclodextrin, an inhibitor of GEM formation. Together with these results, it was strongly suggested that gp49A could be expressed as a homodimer and elicit activation signals that lead to calcium mobilization, eicosanoid production, and cytokine gene transcription through its incorporation into GEM.

Physical performance tests after stroke: reliability and validity

OBJECTIVE

To evaluate the reliability and validity of the modified physical performance tests for stroke survivors who live in a community.

DESIGN

The subjects included 40 stroke survivors and 40 apparently healthy independent elderly persons. The physical performance tests for the stroke survivors comprised two physical capacity evaluation tasks that represented physical abilities necessary to perform the main activities of daily living, e.g., standing-up ability (time needed to stand up from bed rest) and walking ability (time needed to walk 10 m).

RESULTS

Regarding the reliability of tests, significant correlations were confirmed between test and retest of physical performance tests with both short and long intervals in individuals after stroke. Regarding the validity of tests, the authors studied the significant correlations between the maximum isometric strength of the quardriceps muscle and the time needed to walk 10 m, centimeters reached while sitting and reaching, and the time needed to stand up from bed rest.

CONCLUSIONS

The authors confirmed that there were significant correlations between the instrumental activity of daily living and the time needed to stand up from bed rest, along with the time needed to walk 10 m for the stroke survivors. These physical performance tests are useful guides for evaluating a level of activity of daily living and physical frailty of stroke survivors living in a community.

[Therapeutic strategies for Parkinson's disease and guidelines for the 21st century]

Parkinson's disease(PD) is one of the most common neurodegenerative disorders, characterized clinically by resting tremor, rigidity and akinesia. The pathological hallmarks of PD is the loss of neurons of the substantia nigra and the existence of Lewy bodies. Among multifactorial theories of gene-environment interaction supporting the pathogenesis of this disease, recent topics focus on the findings of single gene mutations found in several forms of familial PDs. The mutations of the gene encode the protein alpha-synuclein, UCH-L1 and Parkin located on the chromosomes 4q21-23, 4p and 6p25.2-27 respectively. Molecular pathology and histochemical studies reveal that one of these proteins is closely associated with parts of Lewy bodies, or has the function of the ubiqitin system of protein metabolism. Although the typical PD shows good response to levodopa therapy, its side effects, which arise after 5 to 10 years of treatment, rather narrow the therapeutic window of PD. As a result we must make available various new therapeutic tools in order to prevent disability and get a favourable QOL in the PD patient's life span. The various tools adopted here include surgical treatments, transcraial magnetic stimulation methods, nonconvulsive electric stimulation therapy, and the design of new drugs. In this issue the frontier of PD therapy and research will be reviewed and new promising insights and guidelines for the current century will be discussed.

[Clinical criteria for the diagnosis for PSP]

In attempts to improve the accuracy of its clinical identification, investigators have proposed numerous diagnostic criteria for progressive supranuclear palsy(PSP). We compared with six different sets of previously published criteria for the clinical diagnosis of PSP. Among of them, the NINDS-SPSP criteria are a most prominent diagnostic standard. But in the clinical area, the NINDS-SPSP criteria have some weak point. We plan to make up this point for using the neuroimaging techniques.

[Parkinson's disease and depression]

Up to 40% of cases of Parkinson's disease are associated with the occurrence of depression. The symptoms of the patients' depressive state may be factors such as significant weight change, insomnia or hypersomnia, psychomotor retardation, fatigue or loss of energy, feelings of worthlessness or inappropriate guilt, decreased concentration and indecisiveness, and recurrent thoughts of death or suicidal ideation. Given these conditions, drugs prove ineffective in many cases. Electroconvulsive therapy (ECT) has been reported to be beneficial in cases of drug-resistant depression. ECT has also been applied to Parkinsonian patients with depression and found to be effective with both depression and the Parkinsonian symptom. Transcranial magnetic stimulation(TMS) has recently been investigated for application in cases of depression and has become known as a valuable tool for depression therapy. TMS is easily implemented even in outpatient therapy. TMS will make a great contribution to the therapy of depression with Parkinson's disease.

AMP-Activated protein kinase is activated by the stimulations of G(q)-coupled receptors

The AMP-activated protein kinase (AMPK) functions as a metabolic sensor that monitors cellular AMP and ATP levels. Platelet-activating factor (PAF) activates endogeneous AMPKalpha1 in Chinese hamster ovary cells expressing the PAF receptor coupled with both G(i) and G(q), but its activity was not inhibited after treatment with islet-activating protein. Norepinephrine and bradykinin also activated AMPKalpha1 in cells expressing the G(q)-coupled alpha(1b)-adrenergic receptor and bradykinin receptor, respectively. Stimulations of the G(i)-coupled alpha(2A)-adrenergic receptor, fMet-Leu-Phe receptor, prostaglandin EP3alpha receptor, and G(s)-coupled beta(2)-adrenergic receptor did not activate AMPKalpha1. AMPKalpha1 thus is activated specifically by stimulation of G(q)-coupled receptors. G(q)-coupled receptors transmit the signal for GLUT4 translocation and glucose uptake through an insulin-independent pathway. However, direct activation of AMPKalpha1 with treatment of 5-aminoimidazole-4-carboxamide-1-beta-d-ribofuranoside did not trigger GLUT4 translocation nor stimulate glucose uptake in our cells. Thus, activation of AMPKalpha1 via G(q) is not sufficient to trigger GLUT4 translocation or stimulate glucose uptake.

New types of X-ray computed tomography (CT) with synchrotron radiation: fluorescent X-ray CT and phase-contrast X-ray CT using interferometer

New types of X-ray computed tomography (CT), fluorescent X-ray CT and phase-contrast X-ray CT are being developed for biomedical research. While fluorescent scanning X-ray CT (FXCT) can detect specific contrast elements, or endogenous iodine, at very low content (less than 400 pg iodine of tissue in a volume of 8 x 10(-6) ml), the phase-contrast X-ray CT (PCCT) is a highly sensitive imaging technique to differentiate between different biological tissue types (based on their specific gravity variation) without the use of a contrast agent. Therefore, we can expect functional diagnosis with FXCT, and high contrast, high resolution biological imaging with PCCT. In this paper, a human thyroid gland imaged by FXCT, and a metastatic human cancerous lesion depicted using PCCT are presented. The latter method used a newly manufactured, large, monolithic, X-ray interferometer, which is described in this paper in detail.

Autosomal recessive juvenile parkinsonism

Autosomal recessive juvenile parkinsonism (AR-JP) is a hereditary neurodegenerative disorder characterized by levodopa-responsive parkinsonism with onset before age 40 years and a slowly progressive course. Families with this condition have been described predominantly in Japanese population, occasionally under different names including an autosomal recessive early-onset parkinsonism with diurnal fluctuation (AR-EPDF) or a familial form of juvenile parkinsonism. Recently, the causative gene for AR-JP was mapped on chromosome 6q25.2-q27, and subsequently a novel gene 'parkin' was identified by means of positional cloning. In this manuscript, we review the clinical, pathological and genetical aspects of AR-JP. It would not only promise to provide important insights into the molecular mechanisms of selective degeneration of dopaminergic neurons in AR-JP, but also bring insights into the mechanisms of degeneration of these neurons in Parkinson's disease.

Hedgehog proteins stimulate chondrogenic cell differentiation and cartilage formation

Sonic hedgehog (Shh) and Indian hedgehog (Ihh) are important regulators of skeletogenesis, but their roles in this complex multistep process are not fully understood. Recent studies have suggested that the proteins participate in the differentiation of chondrogenic precursor cells into chondrocytes. In the present study, we have tested this possibility more directly. We found that implantation of dermal fibroblasts expressing hedgehog proteins into nude mice induces ectopic cartilage and bone formation. Immunohistological and reverse-transcription polymerase chain reaction (RT-PCR) analyses revealed that the ectopic tissues derived largely if not exclusively from host cells. We found also that treatment of clonal prechondrogenic RMD-1 and ATDC5 cells in culture with Ihh or recombinant amino half of Shh (recombinant N-terminal portion of Shh [rShh-N]) induced their differentiation into chondrocytes, as revealed by cytoarchitectural changes, Alcian blue staining and proteoglycan synthesis. Induction of RMD-1 cell differentiation by Ihh or rShh-N was synergistically enhanced by cotreatment with bone morphogenetic protein 2 (BMP-2) but was blocked by cotreatment with fibroblast growth factor 2 (FGF-2). Our findings indicate that hedgehog proteins have the ability to promote differentiation of chondrogenic precursor cells and that their action in this process can be influenced and modified by synergistic or antagonist cofactors.

Diurnal variation in the P300 component of human cognitive event-related potential

Diurnal variation in the P300 component of the human cognitive event-related potential (ERP) was examined. The P300 component is considered to be a measure of neuroelectric activity related to cognitive functions such as attention allocation and information processing. Nine diurnally active healthy male subjects whose sleep-wake rhythms were synchronized prior to the experiment were studied. The P300 components oral temperature, heart rate, left- and right-hand grip strength, reaction time, subjectively rated sleepiness, attention level, and fatigue were measured at 08:00, 11:00, 14:00, 17:00, and 20:00. Significant diurnal variations in P300 latency, P300 amplitude, oral temperature, heart rate, left- and right-hand grip strength, subjectively rated sleepiness, and attention level were observed. The P300 latency at 08:00 was significantly longer than at 11:00, 17:00, and 20:00, while the P300 amplitude at 08:00 was significantly greater than at 17:00 and 20:00. The P300 latency was correlated positively with subjectively rated sleepiness and negatively correlated with subjectively rated attention level. These results suggest the existence of diurnal variation in human cognitive functions.

Novel mutations, pseudo-dominant inheritance, and possible familial affects in patients with autosomal recessive juvenile parkinsonism

Autosomal recessive juvenile parkinsonism is a hereditary neurodegenerative disorder, usually beginning before the age of 40. We found three exonic deletions and two novel point mutations (Arg33Stop and Cys431Phe) in six families with autosomal recessive juvenile parkinsonism. In 1 family, in which an autosomal dominant mode of inheritance was suspected, multiple mutant alleles were identified. Although a wide range of ages at onset was observed, there was no correlation between age at onset and genotype.

Detection of circulating cancer cells by reverse transcription-polymerase chain reaction for uroplakin II in peripheral blood of patients with urothelial cancer

Few attempts have been made at the molecular detection of urothelial cancer cells in the blood or lymph nodes mainly because of an absence of good candidate molecular or genetic changes specific to urothelial cancer or urothelium. In 1990, however, genes that encode urothelium-specific transmembrane proteins, uroplakins (UPs), were cloned. We have established a method of detecting circulating cancer cells in peripheral blood of patients with transitional cell carcinoma by nested reverse transcription-PCR assay for UP II. UP II mRNA-positive cells were detected in 3 (10.3%) of 29 patients with superficial cancers (pTa-1N0M0), 4 (28.6%) of 14 patients with muscularly invasive cancers (pT2-4N0M0), 2 (40.0%) of 5 loco-regional node-positive patients (pN1-2M0), and 6 (75.0%) of 8 patients with distant metastases. Positive rates, therefore, increased with tumor extension (P = 0.0033, Kruskal-Wallis test). Furthermore, sequential blood sampling was performed in three patients with metastases during and after systemic chemotherapy, and UP-II-positive cells were found to have disappeared in two patients who responded well to the systemic chemotherapy. These results suggest that our nested reverse transcription-PCR assay for UP II is highly specific and might be used as a tumor marker for molecular staging of urothelial cancers, although the sensitivity is not so optimal.

New plasma-reduced synthetic media, Fukushima cocktails, for the storage of platelets for transfusion

BACKGROUND

Donor plasma proteins are associated with non-hemolytic allergic reactions, such as urticaria or laryngeal edema, in platelet-transfusion recipients. Replacement of plasma with synthetic media from platelet concentrates (PCs) is considered to be effective in preventing such reactions. However, platelets preserved in media depleted of less than 10% plasma are reported to have functions inferior to those preserved in plasma.

METHODS

Fukushima Cocktails (FCs) contain glycerol (25, 50 or 100mM), sodium acetate, glucose and other components. To test the effect and determine the most suitable concentration of glycerol for platelet preservation, functions of platelets including aggregation, hypotonic shock response and swirling pattern and released biochemicals were measured with platelets preserved in Fukushima Cocktails. The effects of residual plasma on platelet functions were also evaluated. Autologous platelets stored for 3 days in solution containing 50 mM glycerol were transfused into healthy volunteer donors to evaluate their safety and survival.

RESULTS

The functions (aggregation and hypotonic shock response) of platelets preserved in Fukushima Cocktails with 10% residual plasma were preserved for 5-7 days as well as plasma controls, whereas platelets stored for 9 days in a medium lacking glycerol became swollen and beta-thromboglobulin and thromboxane B(2) increased. When the residual plasma was more than 5%, platelet functions including aggregation, hypotonic shock response and swirling pattern were well preserved for 7 days. The in vivo platelet survival rates at 24 and 48 h after transfusion of platelets stored for 3 days in Fukushima Cocktail were 77% and 60%, respectively, which were not less than autologous plasma-stored platelets.

CONCLUSION

Glycerol at a concentration of around 50 mM has a beneficial effect on platelet preservation for more than 7 days. The results of these experiments indicate that platelets stored in Fukushima Cocktail should be useful clinically.