Positron emission tomography in cases of chorea with different underlying diseases

Local cerebral metabolic rate for glucose (LCMRglc) was measured with positron emission tomography using the 18F-fluorodeoxy-glucose method in five patients with chorea due to different underlying diseases. Hypometabolism was observed in the striatum bilaterally in patients with Huntington's disease, choreoacanthocytosis, sporadic progressive chorea and dementia, and pseudo-Huntington form of dentato-rubro-pallido-luysian atrophy (DRPLA). The patient with hemichorea showed hypometabolism in the striatum on the contralateral side to the chorea. The patient with pseudo-Huntington form of DRPLA showed a diffusely decreased LCMRglc in other structures including the cerebral cortex, thalamus and cerebellum. These findings indicated that dysfunction of the striatum is relevant to the genesis of chorea in all these patients, even though the extent of dysfunction in other structures is different in each case.

[Clinical study of the relationship between unknown etiology of renal hematuria and serum zinc concentrations]

The relationship between red blood cell counts in urine of 165 patients with unknown etiology of renal hematuria and serum zinc levels was examined. There was a significant negative correlation between red blood counts in urine and serum zinc levels. The clinical course and changes of serum zinc levels of 2 cases (case 1: 21 years old female, case 2: 46 years old male) with unknown etiology of renal hematuria are reported. Serum zinc levels showed the clinical stage of unknown etiology of renal hematuria. Renal biopsy should be done in patients with low serum zinc levels and renal hematuria continuing for a long time. Clinically, serum zinc level could be used as a marker of effect of treatment for unknown etiology of renal hematuria. Serum zinc levels were low in 165 patients with renal hematuria.

Antitumor effect of adriamycin entrapped in liposomes conjugated with anti-human alpha-fetoprotein monoclonal antibody

The monoclonal antibody, 19-F-12 (IgG2b), against human alpha-fetoprotein was conjugated to liposomes containing Adriamycin, and the therapeutic effects of the conjugate were experimentally studied using the alpha-fetoprotein-producing human hepatoma strain, Li-7, maintained in BALB/c nu/nu male mice. Three i.v. injections of liposomes containing Adriamycin (7.5 mg/kg) into tumor-bearing mice significantly inhibited the tumor growth, and the therapeutic effect of the antibody-conjugated liposomes was greater than that of unconjugated liposomes, as judged from the tumor weights and histological findings. Furthermore, the experiments were repeated with Adriamycin (4-5 mg/kg) in free form, since administration of Adriamycin (7.5 mg/kg) in free form was highly toxic for the mice. The results still indicated that the therapeutic effect of Adriamycin in 19-F-12 conjugated liposomes was superior to that of free Adriamycin or Adriamycin in unconjugated liposomes. In contrast to the treatment for Li-7 in nude mice, the therapeutic effect of Adriamycin in 19-F-12 conjugated liposomes was not much different from that of Adriamycin in normal mouse IgG (IgG2b fraction) conjugated liposomes against alpha-fetoprotein-negative human breast cancer strain MX1. Tissue distribution studies after i.v. injection of Adriamycin in various forms into mice revealed that preferential delivery of Adriamycin to tumors occurred to some extent with antibody-conjugated liposomes as compared to the unconjugated liposomes. In addition, reduction of the distribution of Adriamycin to the heart was achieved by administering the drug in the liposome-entrapped form, and this enabled the use of a higher dose (7.5 mg/kg) of Adriamycin without toxic side effect.

Electrophysiological study on limb myokymia in three women

Physiological studies on three women with limb myokymia were carried out. The patients had diabetic neuropathy, neuromyotonia, and autonomic polyneuropathy, respectively. The EMG discharge pattern, coincident with myokymia, in a patient with myokymia and neuromyotonia differed from those with myokymia without neuromyotonia. In only the first patient did the electrical stimulation of nerves evoke "late repetitive response" (LRR), which resembled the wave forms of the myokymic discharge. Epidural and peripheral nerve blocks abolished myokymia in the first and second cases, but peripheral nerve block was without effect in the third patient. These findings indicate that myokymia originates in multiple sites of alpha motor neurons and that the pathophysiology may vary.

Altered local cerebral glucose utilization induced by electrical stimulations of the thalamic sensory and parafascicular nuclei in rats

Alterations in local cerebral glucose utilization (LCGU) induced by electrical stimulation of the sensory relay nucleus (VPL) or parafascicular nucleus (Pf) of the thalamus in conscious rats were measured by the [14C]2-deoxyglucose method, the objective being to assess the mechanism of analgesia induced by electrical stimulations of these structures. Stimulation of the VPL induced an ipsilateral increase in LCGU in the sensory thalamic nucleus itself, the sensory cortex and substantia nigra. Stimulation of the Pf induced bilateral increases in LCGU in the Pf and central medial nucleus of the thalamus, sensory cortex, ventral areas of the striatum and substantia nigra, and ipsilateral increase in LCGU in the periaqueductal gray, parabrachial pontine nucleus and deep layers of the superior colliculus. No significant change in LCGU was detected in the raphe dorsalis, raphe magnus and spinal dorsal horn, in both groups. Our observations coincide with clinical findings that unilateral electrical stimulation of the Pf leads to amelioration of intractable pain bilaterally, while that of the VPL induces an analgesia restricted to the contralateral side.

Regular stripe-like activation and suppression of metabolic activity in the cerebellar cortex following apomorphine administration to haloperidol-pretreated rats

Alteration of the pattern of metabolic activity in the cerebellar cortex, as produced by apomorphine in rats given chronic pretreatment with haloperidol was studied by means of the [14C]deoxyglucose method. Apomorphine induced a regular stripe-like activation and suppression of metabolic activity in the caudal paravermal area of the cerebellar hemisphere and in the caudal vermis of the cerebellar cortex. This stripe-like pattern, oriented perpendicularly to the cerebellar fissure, suggests the functional organization of the cerebellar cortex in a direction which is parallel to the longitudinal axis of folia.

Serum and corpuscular nickel and zinc in chronic hemodialysis patients

Serum and corpuscular nickel and zinc concentrations in 30 chronic hemodialysis patients were examined. Serum nickel and zinc levels before dialysis were 0.22 +/- 0.03 microgram/dl (normal value: 0.56 +/- 0.08 microgram/dl) and 70.0 +/- 13.4 micrograms/dl (normal value: 96 +/- 8 micrograms/dl) low, respectively. However, corpuscular nickel and zinc levels before dialysis were high: 1.25 +/- 0.24 microgram/dl (normal value: 0.88 +/- 0.17 microgram/dl) and 1,299 +/- 146 micrograms/dl (normal value: 1,120 +/- 80 micrograms/dl). Serum zinc levels significantly increased after dialysis, but serum nickel concentrations did not significantly increase during dialysis. Corpuscular nickel and zinc concentrations did not significantly change during dialysis.

Male urethral tumour (condyloma acuminatum): urethrographic and endoscopic appearances

Two cases of condyloma acuminatum of the male urethra were clearly demonstrated by retrograde urethrogram and endoscopy. Characteristic urethrographic and endoscopic appearances of these cases are presented.

Zinc transport during hemodialysis

Zinc transfer during hemodialysis and plasma zinc concentrations in hemodialysis patients were examined. Fifteen volunteer outpatients undergoing hemodialysis showed significant increases in plasma zinc from 74.0 +/- 7.8 to 88.1 +/- 9.7 micrograms/dl after a 5-h dialysis. The increase was mainly the result of hemoconcentration as evidenced by a significant increase in the hematocrit and total serum protein during dialysis, but was also due to diffusion. To study the changes resulting from diffusion, zinc was measured in the arterial blood and in the dialysate at the inflow and outflow sites of the dialyzer. There was a significant (p less than 0.01) increase in the plasma zinc of the arterial blood from 74.7 +/- 8.1 to 80.2 +/- 6.5 micrograms/dl, but a nonsignificant decrease in the dialysate zinc from 10.6 +/- 2.5 to 9.5 +/- 5.9 micrograms/dl. Zinc diffused across the dialyzer from the dialysate to the blood in 12 cases and into the dialysate in three others.

Relationship between haemodialysis anaemia and copper and zinc

In fifteen chronic haemodialysis patients, serum and corpuscular copper and zinc concentrations were examined before and after dialysis. Serum copper levels were normal before dialysis and elevated after dialysis. However, corpuscular copper levels were low before dialysis and did not change after dialysis. Serum zinc concentrations before dialysis were low and significantly increased after dialysis. Corpuscular zinc levels before dialysis were high, but were unchanged after dialysis. There was a good correlation between serum zinc levels and red blood cell counts (RBC) and the value of haemoglobin (Hb), whereas we found no significant correlation between levels of serum or corpuscular copper and zinc, and of RBC, Hb, haematocrit or serum iron.

Altered local cerebral glucose utilization by unilateral frontal cortical ablations in rats

Alterations in local cerebral glucose utilization (LCGU) following ablations of the unilateral frontal cortex in rats were studied to elucidate the effect of the lesion on the functional activity in the related cerebral structures. Frontal cortical ablations (areas 2, 4, 6 and 10) were made by aspiration on the left side, and LCGU was evaluated at 7 days after the operation, using the [14C]deoxyglucose method. Significant decreases in LCGU in rats with unilateral frontal cortical ablations, were observed in the ipsilateral thalamic nuclei (ventroanterior-ventrolateral (VAL), ventrobasal (VB), reticular), red nucleus and pontine nucleus. The ipsilateral globus pallidus showed a significant LCGU increase. The contralateral cerebellar cortex showed a tendency toward a decrease in LCGU. The striatum, which receives direct projections from the frontal cortex, showed no LCGU change. These results indicated that ablations of unilateral frontal cortex in rats produced LCGU changes in the cerebral structures which have direct or indirect neuronal connections with the ablated area. These LCGU changes were, for the most part, brought about by alteration in the neuronal activity. Particularly, the LCGU increase in the globus pallidus which receives transsynaptic neuronal input from the frontal cortex, without changes in the striatum, which receives direct projection, was attributed to the functional alteration of the globus pallidus produced by the cortical ablation. Destructive lesion of a cerebral structure, therefore, does not necessarily cause functional depressions in the pertinent structures, but it may enhance the function of some structures, depending on the functional characteristics of each neuronal connection and functional organization of those structures.

Serum copper concentration changes in chronic hemodialyzed patients

We studied the behavior of copper during hemodialysis and the relationship between serum copper levels and hematologic parameters such as red blood cell count (RBC), hematocrit (Hct), hemoglobin (Hb), and serum iron in 48 hemodialyzed patients. To study diffusion, we measured copper in the arterial blood and in the dialysate at the inflow and outflow sites of the dialyzer. To study hemoconcentration, the change in hematocrit values and total serum protein values were examined. To study liberation of copper from the dialyzer membrane, copper concentrations in normal saline were measured before and after the saline was used to wash dialyzers of various kinds. We found that changes in serum copper concentration were due mainly to hemoconcentration and liberation, but partly also to diffusion, and that the net result of changes was a significant increase in serum copper. We observed no correlation between serum copper levels and RBC, Hct, Hb, and serum iron levels.

Local cerebral glucose utilization altered in rats with unilateral electrolytic striatal lesions and modification by apomorphine

Alterations in local cerebral glucose utilization (LCGU) in rats with unilateral striatal lesions and the modification by apomorphine were investigated. Electrolytic lesions were made in the rostral part of the right striatum, and 1, 7, and 30 days later, LCGU was observed in terms of relative and absolute LCGU values, using the [14C]deoxyglucose method. A definite change in the pattern of LCGU was seen only at 7 days. These were increases in LCGU in the globus pallidus, entopeduncular nucleus and substantia nigra pars reticulata, and decreases in the ventroanterior-ventrolateral (VAL) and ventromedial (VM) thalamic nuclei and lateral habenula, all on the lesioned side. The circling behavior following the lesion, however, was maximal after 2 days and disappeared after 7 days. Intravenous administration of apomorphine (1.5 mg/kg) produced different modifications in the LCGU pattern between the intact and lesioned sides, at 7 days after producing the lesions. On the intact side, there were increases in LCGU in the striatum, globus pallidus, entopeduncular nucleus, substantia nigra pars reticulata and subthalamic nucleus, and a decrease in the lateral habenula. No such changes were observed on the lesioned side. These results indicate firstly that electrolytic striatal lesions induce LCGU increases or decreases in the structures which receive the striatal input, secondly that the mechanism of this change differs from that of the circling behavior seen in case of striatal lesions, and finally that the majority of the LCGU changes in the basal ganglia and thalamus following intravenous administration of apomorphine are brought about by an altered input of neuronal activity from the striatum to these structures.

[Effect of cefaclor in urinary tract infections (2)]

A second part of our continuous investigation on the clinical effect of cefaclor (CCL) against urinary tract infections was reported herein. CCL, a daily dose of 0.75 g t.i.d., has been applied for the treatment of (I) 76 cases with the uncomplicated acute cystitis in the women, and (II) 55 cases with the complicated. Rates of effectiveness were obtained 98.7% in (I) and 60% in (II). Side effects were noted in 13 cases out of total 150 cases.

[Primary hyperparathyroidism associated with bladder tumor: report of a case]

A 47-year-old man was admitted with chief complaints of macroscopic hematuria and bone pain. Hypercalcemia still remained after three small papillary tumors on the left retrotrigonal wall of the bladder were resected transurethrally. Some biochemical as well as X-ray examinations thereafter pointed out an association with primary hyperparathyroidism. An adenoma arising from right upper parathyroid gland was found and excised. Then his symptoms, both subjective and objective, were normalized. Six documented cases of primary hyperparathyroidism associated with urological malignancy including our own were found in the Japanese literature.

[Effect of cefadroxil in urinary tract infections]

Clinical effect of cefadroxil (CDX) against urinary tract infections was reported herein. CDX, a daily dose of 0.75 g t.i.d., has been applied for the treatment of (I) 40 cases with simple UTI for average 6.4 days and (II) 47 cases with the complicated UTI for average 8.9 days. Rates of effectiveness were obtained 95% in (I) and 57% in (II). Side effects were noted in 10 cases (9.3%) out of total 107 cases.

[Bilateral asynchronous ureteral tumors associated with a horseshoe kidney: a case report]

A case of bilateral asynchronous ureteral tumors in a 58-year-old man associated with a horseshoe kidney was reported. First, left heminephrectomy with total left ureterectomy had been performed because of the left ureteral carcinoma. Three years and 8 months later, he was admitted and an emergency right nephrostomy was made on account of false anuria. Then, right ureterectomy with total cystectomy was the choice of treatment against the ureteral tumor on the right side. This case of bilateral ureteral tumors associated with a horseshoe kidney appears to be the first one reported in the Japanese literature.

Acute Renal Failure following Intraperitoneal Injection of Cis-Diamminedichloroplatinum

Cis-diamminedichloroplatinum (cis-DDP) has been used intravenously as a good anticancer agent despite its nephrotoxicity, but local administration may also cause nephrotoxic side effects. We used intraperitoneal injection of cis-DDP into male Wistar rats as a model of the long-term effect of local administration of cis-DDP. 20 rats were injected (1.5 mg/kg) every 2 days for a period of 5 weeks and compared to a control group of 5 rats that did not receive injection. In the control group, body weight increased gradually to 338.3 +/- 25.1 g by the end of week 5. In contrast, the experimental group's body weight decreased continually to 179.5 +/- 23.6 from an average initial weight of 218.0 +/- 4.0 g. While the control group had steady values, the experimental rats showed sharp increases in blood urea nitrogen, serum creatinine, potassium and sodium, but a decrease in hematocrit. On histological examination at autopsy, edema and necrosis of the renal tubules were evident. Intraperitoneal injection of cis-DDP in rats causes nephrotoxic side effects similar to the effects caused by intravenous injection.

[A case of mediastinal parathyroid adenoma with primary hyperparathyroidism]

A 21-year-old man with a history of recurrent urolithiasis was admitted. Hypercalcemia was found and a diagnosis of primary hyperparathyroidism was made. Neck exploration was performed without success. Localization studies were done. Repeated selective arteriography revealed a mediastinal parathyroid adenoma. CT scan as well showed the adenoma in the anterior mediastinum. Ultrasonotomography, 201Tl-chloride and 131I scintigraphy with subtraction image and two venous samplings were negative. Mediastinal exploration with partial sternotomy was performed and a parathyroid adenoma was subsequently removed. Serum calcium and phosphorous levels were normalized, several postoperative days.

Topographical distribution of propagation of seizure activity in the basal ganglia during focal motor seizures in the monkey

Topographical distribution of the propagation of seizure activity in the basal ganglia was studied during focal motor seizures from the focus in the face-hand area of Area 4 in the monkey, using the [14C]deoxyglucose autoradiography method. The focal seizures were induced by injecting potassium penicillin G into the face-hand area in the right motor cortex. The propagation of seizure activity in the basal ganglia was localized in the ventral and caudal parts of the ipsilateral putamen and globus pallidus lateral and medial segments, and in part of the reticular portion of substantia nigra. These areas in the basal ganglia seem to be functionally linked to the face-hand area of the motor cortex.

Congenital renal anomaly: evaluation with 99mTc-dimercaptosuccinic acid renal scintigraphy

Technetium 99m-2,3, dimercaptosuccinic acid (99mTc-DMSA) preferentially accumulates in the renal cortex, demonstrating functioning cortical mass. We used 99mTc-DMSA renal scintigraphy in ten patients with horseshoe kidneys and five patients with unilateral fused kidneys. The results show that 99mTc-DMSA renal scintigraphy reliably establishes the diagnosis of horseshoe kidney and clearly shows the isthmus, which is very essential for proper management. The technique also aids in the definitive assessment of separate kidney function and of total radionuclide uptake is possible using 99mTc-DMSA scintigraphy.

Syndrome of continuous muscle-fiber activity: increased CSF GABA and effect of dantrolene

In a patient with a syndrome of continuous muscle fiber activity, peripheral nerve block completely abolished the EMG discharges. Reduction of spontaneous discharges by epidural block and demonstration of a silent period after the H response suggested that the disorder may originate in the spinal cord or ventral roots, sparing inhibitory influences on the alpha-motoneuron to some extent. GABA (gamma-aminobutyric acid) content in CSF was remarkably increased. Therapeutically, dantrolene sodium was as effective as phenytoin or carbamazepine.

[Effect of cefaclor in urinary tract infections (the first report)]

A part of our continuous investigation on the clinical effect of cefaclor against urinary tract infections was reported herein. Cefaclor, a daily dose of 0.75 g t.i.d., has been applied for the treatment of (I) 26 cases with the simple UTI and (II) 41 cases with the complicated. Rates of effectiveness were obtained 100% in (I) and 80% in (II). Side effects were noted in 8 cases (8.4%) out of total 95 cases.

Primary retroperitoneal seminoma

We describe a case of primary retroperitoneal seminoma with metastasis to the left kidney, left adrenal gland, and other organs without evidence of testicular involvement. We determined this disease at autopsy.

Dentatorubropallidoluysian degeneration: clinical, neuro-ophthalmologic, biochemical, and pathologic studies on autosomal dominant form

Four cases in two generations of a Japanese family are described as affected by an autosomal dominant-inherited cerebellar ataxia, pyramidal and extrapyramidal signs, and abnormal ocular movements, resembling Machado-Joseph disease. The neuro-ophthalmologic examination suggests the involvement of multiple motor control systems. The neuropathologic examination of one case showed neuronal loss in the subthalamic nuclei, pallidum, dentate nuclei of cerebellum, and red nuclei, which is distinct from Machado-Joseph disease.

Increased local cerebral glucose utilization in the basal ganglia of the rolling mouse Nagoya

Rolling mouse Nagoya (rolling), an experimental mutant mouse, is characterized by a marked incoordination of the hind limbs and disturbance of gait. These motor disturbances have been attributed to cerebellar dysfunction, and rolling, therefore, has been regarded as an animal model of hereditary cerebellar ataxia. However, definite evidence for this possibility has not yet been provided. In the present study, local cerebral glucose utilization (LCGU) was observed by means of the [14C]deoxyglucose method in rolling (rol/rol), as well as in behaviorally normal heterozygotes (+/rol) and normal controls (+/+), in order to study functional activity of the brain in these mice. A definite increase in LCGU was found in the globus pallidus, entopeduncular nucleus, subthalamic nucleus, and substantia nigra of rolling, bilaterally. A minimal decrease in LCGU was also found in the vermis of the cerebellum. These findings reflect the markedly hyperactive state of the basal ganglia and the minimally hypoactive state in the vermis of the cerebellum in rolling. It is concluded that the dysfunction in the basal ganglia is the major cause of the motor disturbances of rolling, and that rolling may be regarded as an animal model of extrapyramidal motor disturbance.

Investigation of the heterogeneity of heterogalactan from the fruit bodies of Fomitopsis pinicola, by employing concanavalin A-Sepharose affinity chromatography

A heterogalactan was isolated from the hot water extract of fruit bodies of Fomitopsis pinicola by a combination of fractionation procedures including precipitation with ethanol and with Cetavlon, and chromatography on columns of DEAE-cellulose and Sephadex G-100. Despite its apparent homogeneity on gel filtration, zone electrophoresis, sedimentation equilibration, and immunodiffusion analyses, the neutral component of heterogalactan was further fractionated into unbound, weakly bound, and strongly bound forms by affinity chromatography on a column of concanavalin A-Sepharose CL 4B. The former two polysaccharides fractions eluted with 0.1 M phosphate buffer (pH 7.0) were found to be a fucogalactan and a mannofucogalactan, respectively. A more tightly bound fraction (mannofucogalactan) was subsequently eluted with 0.1 M glucose in 1 M NaCl. The results of methylation, complete Smith degradation, and proton and 13C NMR spectroscopic analyses indicated that the three kinds of heterogalactans are all highly branched polysaccharides containing a framework of (1 leads to 6)-linked alpha-D-galactopyranosyl residues, the C-2 positions of which are substituted in different proportions with either single L-fucopyranosyl residues or disaccharide units of 3-O-alpha-D-mannopyranosyl-L-fucopyranose residues.