Reduced Complexity Model Intercomparison Project Phase 2: Synthesizing Earth System Knowledge for Probabilistic Climate Projections

Over the last decades, climate science has evolved rapidly across multiple expert domains. Our best tools to capture state-of-the-art knowledge in an internally self-consistent modeling framework are the increasingly complex fully coupled Earth System Models (ESMs). However, computational limitations and the structural rigidity of ESMs mean that the full range of uncertainties across multiple domains are difficult to capture with ESMs alone. The tools of choice are instead more computationally efficient reduced complexity models (RCMs), which are structurally flexible and can span the response dynamics across a range of domain-specific models and ESM experiments. Here we present Phase 2 of the Reduced Complexity Model Intercomparison Project (RCMIP Phase 2), the first comprehensive intercomparison of RCMs that are probabilistically calibrated with key benchmark ranges from specialized research communities. Unsurprisingly, but crucially, we find that models which have been constrained to reflect the key benchmarks better reflect the key benchmarks. Under the low-emissions SSP1-1.9 scenario, across the RCMs, median peak warming projections range from 1.3 to 1.7°C (relative to 1850-1900, using an observationally based historical warming estimate of 0.8°C between 1850-1900 and 1995-2014). Further developing methodologies to constrain these projection uncertainties seems paramount given the international community's goal to contain warming to below 1.5°C above preindustrial in the long-term. Our findings suggest that users of RCMs should carefully evaluate their RCM, specifically its skill against key benchmarks and consider the need to include projections benchmarks either from ESM results or other assessments to reduce divergence in future projections.

Practices for Supporting and Confirming Decision-Making Involved in Kidney and Liver Donation by Related Living Donors in Japan: A Nationwide Survey

This nationwide survey investigated the actual practices for supporting and confirming the decision-making involved in related living-organ donations in Japan, focusing on organ type and program size differences. Answers to a questionnaire survey were collected from 89 of the 126 (71%) kidney and 30 of the 35 (86%) liver transplantation programs in Japan that were involved in living-donor transplantations in 2013. In 70% of the kidney and 90% of the liver transplantation programs, all donors underwent "third-party" interviews to confirm their voluntariness. The most common third parties were psychiatrists (90% and 83%, respectively). Many programs engaged in practices to support decision-making by donor candidates, including guaranteeing the right to withdraw consent to donate (70% and 100%, respectively) and prescribing a set "cooling-off period" (88% and 100%, respectively). Most donors were offered care by mental health specialists (86% and 93%, respectively). Third parties were designated by more of the larger kidney transplant programs compared with the smaller programs. In conclusion, the actual practices supporting and confirming the decision to donate a living organ varied depending on the organ concerned and the number of patients in the program.

Intraventricular administration of the neurotrophic factor midkine ameliorates hippocampal delayed neuronal death following transient forebrain ischemia in gerbils

Midkine (MK) is a growth factor with neurotrophic activities, and is expressed during the early stages of experimental cerebral infarction in rats in the zone surrounding the infarct. To evaluate in vivo activity of MK in preventing neuronal death, MK produced in yeast (Pichia pastoris) was administered into the brain ventricle immediately before occlusion of the bilateral common carotid artery of Mongolian gerbils. MK administration at the dose of 0.5-2 microg immediately before occlusion was found to ameliorate delayed neuronal death in the hippocampal CA1 region caused by transient ischemia 7 days after the insult. The hippocampal neurons of the MK-administered gerbils tended to degenerate 14 and 21 days after the insult, but their numbers remained higher than those in saline-administered controls; however, the hippocampal neurons were degenerated 28 days after the insult. MK administration at 2 h after occlusion did not ameliorate the neuronal death. These findings suggested that the therapeutic time window was narrow. The two to four times repeated administration of 2 microg MK immediately before and at 1, 2, or 3 weeks after the occlusion were not significantly different for the hippocampal neuronal death at 28 days after the insult compared with a single injection, but were significantly effective compared with vehicle administration alone. These findings suggested that the therapeutic time window was relatively narrow. The potent neuroprotective activity of MK observed in vivo suggested that MK might be useful as a therapeutic reagent for prevention of neuronal death in neurodegenerative diseases.

N-cadherin expressed on malignant T cell lymphoma cells is functional, and promotes heterotypic adhesion between the lymphoma cells and mesenchymal cells expressing N-cadherin

Cadherins are Ca2+-dependent cell-cell adhesion molecules, and are involved in the formation and maintenance of the organocellular architecture. Using a combination of molecular biologic and biochemical methods, we analyzed cadherins expressed on cultured human malignant lymphoma cell lines (adult T cell lymphomas, human T cell leukemia virus type 1-negative T cell lines, and thymus-derived lymphoma cell lines), and obtained evidence that N-cadherin is the major cadherin expressed on these cells. These cells were found to form cell aggregates in a Ca2+-dependent manner, and more importantly to coaggregate and adhere with cells expressing N-cadherin, suggesting that N-cadherin on lymphoma cells is functionally active. Therefore, N-cadherin expressed on lymphoma cells could underlie the frequent invasion of these cells into the mesenchymal tissue in the skin and the central nervous system.

Midkine exists in astrocytes in the early stage of cerebral infarction

Midkine (MK), a heparin-binding neurotrophic factor, is expressed in the early stage of experimental cerebral infarction in the zone surrounding the infarct. Double immunostaining with anti-MK and anti-glial fibrillary acidic protein showed existence of MK in astrocytic cytoplasm on postoperative day 2. Immunoelectron microscopic analysis revealed the presence of MK in the swollen astrocytic processes on postoperative day 4.

Myocardial infarction induces expression of midkine, a heparin-binding growth factor with reparative activity

We examined midkine (MK) expression in the rat heart upon experimental myocardial infarction. Immunohistochemical staining revealed, 6 hours after ligation of the left anterior descending coronary artery, strong MK immunoreactivity in myocytes and endothelial cells of a non-infarcted cardiac region. The myocytes of the infarcted cardiac region destined for death showed only a little immunoreactivity. Northern blot analysis suggested that the increased immunoreactivity was due to increased MK synthesis. The induced MK expression is likely to mimic the expression during embryogenesis: MK was strong lye-expressed in the myocytes of embryonic heart, and the expression decreased during embryogenesis.

Heparin binding protein-44 (HBP-44)/receptor-associated protein (RAP)mediates cell-substratum adhesion of mouse NIH/3T3 cells through its binding to low density lipoprotein (LDL) receptor-related protein (LRP)

The low density lipoprotein receptor-related protein (LRP) is a multifunctional endocytic receptor with the ability to bind and endocytose several structurally and functionally distinct ligands. The 39 kDa receptor-associated protein (RAP) is an endoplasmic reticulum (ER) resident protein, which is believed to function intracellularly as a molecular chaperone for LRP and to regulate its ligand binding activity along the secretory pathway. Mouse heparin binding protein-44 (HBP-44) is a homologue of human RAP. Using a recombinant form of HBP-44 expressed in Escherichia coli cells as a highly specific ligand for LRP, we demonstrated that HBP-44 coated on cell culture plates mediates the cell-substratum adhesion of mouse 3T3 fibroblasts in a dose-dependent manner, with 50% attachment at the concentration of 0.2 micrograms/ml. Ligand blot analysis with HBP-44 of whole cell extracts and the materials precipitated by anti-LRP antibodies revealed that the receptor for HBP-44 on NIH/3T3 cells was LRP. The results suggest that LRP serves as a cell adhesion receptor in some cells.

Midkine as a novel target gene for the Wilms' tumor suppressor gene (WT1)

Midkine (MK) is a heparin-binding growth factor which is strongly expressed during the midgestation period of mouse embryogenesis. Wilms' tumor is an embryonal kidney malignancy in infants, and WT1 has been identified as its tumor suppressor gene. The high expression level of MK in all Wilms' tumor specimens so far examined and the presence of two WT1 elements (5'-GCGGGGGCG-3') in the human MK promoter region led us to examine the possible role of the WT1 gene product in the regulation of MK gene expression. A gel shift assay verified the complex formation between the WT1 gene product and WT1 consensus sequence of MK gene. DNase1 footprint analysis also demonstrated that the downstream WT1 element was protected from DNase1 cleavage by the addition of the WT1 protein. The human MK promoter fused with the chloramphenicol acetyltransferase gene (phMK2.3kCAT) was co-transfected with an effector plasmid containing the WT1 gene into several cell lines. Transient transfection assays showed suppression of the MK promoter by WT1 co-transfection in recipient cells; deletion of the WT1 binding site abolished the suppression. The evidence reported in this study indicates that MK gene is a newly identified WT1 target gene.

Expression of cadherin-catenin complexes in human leukemia cell lines

Cadherins are Ca2(+)-dependent cell-cell adhesion molecules, and are involved in the formation and maintenance of the histo-architecture. Using cultured human leukemia cell lines (adult T cell leukemia and thymus-derived lymphoma cell lines), we obtained evidence that cadherins and catenins are expressed in these cell lines but not in normal leukocytes. Immunoblot analysis of cells using a pan-cadherin serum, directed against the conserved carboxyl-terminus of cadherins, revealed a major band of 130 kDa and a minor one of 135 kDa. The 130 kDa cadherin was also recognized by anti-N-cadherin antibodies. A human N-cadherin cDNA probe hybridized to a 4.3 kb mRNA isolated from cells immunologically positive for N-cadherin. Sequencing of the cDNA fragments isolated from the cells revealed a N-cadherin sequence. Cell surface expression of N-cadherin was confirmed by indirect immunofluorescence staining of the cells. Immunoblot and Northern blot analyses also revealed the presence of alpha-catenin, beta-catenin, and gamma-catenin (plakoglobin) in these cell lines. Immunoprecipitation with anti-N-cadherin antibodies and subsequent immunoblot analysis with anti-catenin antibodies revealed that N-cadherin is associated with alpha- and beta-catenins, a prerequisite for cadherins to be functional. These results suggest an important role of the cadherin-catenin complexes in the behavior of the leukemia cells.

Enhanced E-cadherin expression and increased calcium-dependent cell-cell adhesion in human T-cell leukemia virus type I Tax-expressing PC12 cells

Human T-cell leukemia virus type I (HTLV-I) Tax protein induces the expression of host cellular genes, some of which are crucial in cell proliferation and differentiation. We examined the mechanisms by which HTLV-I Tax protein induces phenotypic changes in PC12 cells. We demonstrated that the HTLV-I Tax gene induces epithelioid changes and increases cell-cell contact in PC12 cells. No change in the expression of the neural cell adhesion molecule was observed between HTLV-I Tax-expressing PC12 cells and PC12 cells transfected with a control plasmid. However, HTLV-I Tax-expressing PC12 cells demonstrated a marked change in the abundance and distribution of E-cadherin, which was concentrated at regions of cellular contact and accompanied by changes in calcium-dependent cell adhesion. Although E-cadherin is expressed at low levels in PC12 and PC12 transfected with a control plasmid cells, the steady state level of E-cadherin in tax-expressing PC12 cells increases significantly, apparently as a result of regulation at the transcriptional level. Diminished expression of Tax protein in Tax-expressing PC12 cells exposed to antisense oligonucleotides for the Tax gene suppresses E-cadherin expression and decreases cell-cell adhesion. These findings imply that HTLV-I Tax protein enhanced E-cadherin expression modulates calcium-dependent cell-cell adhesion mechanisms.

Midkine (MK) expression in extraembryonic tissues, amniotic fluid, and cerebrospinal fluid during mouse embryogenesis

Midkine (MK) and pleiotrophin (PTN) constitute a new family of heparin-binding growth factors. Extraembryonic membranes and the placenta of the mouse expressed MK mRNA at 11.5 days gestation. While the MK mRNA level in extraembryonic membranes decreased during embryogenesis, that in the placenta remained unchanged. Immunohistochemical studies showed that Mk was located in the yolk sac and in the amnion at 11.5 days gestation. PTN mRNA expression was weak in extraembryonic membranes and was scarcely detectable in the placenta. Western blot analysis revealed the presence of MK in amniotic fluid and cerebrospinal fluid, in amounts of more than 1 microgram/ml, raising the possibility that MK delivered by these fluids participates in the regulation of organogenesis. Transport of MK from the site of its synthesis appears to also occur in the adult kidney, since MK mRNA and the MK protein are localized in different regions of the kidney.

Increased midkine gene expression in human gastrointestinal cancers

Midkine (MK) is a product of a retinoic acid-responsive gene, and is a novel growth differentiation factor. We examined the expression of the MK gene in specimens of 47 surgically removed human carcinomas of the gastrointestinal organs, namely, gastric, colorectal, hepatocellular, pancreatic, esophageal, ampullary duodenal and bile duct carcinomas. In most cases, the MK mRNA level was higher in cancer specimens than in the corresponding non-cancerous tissues. Furthermore, MK mRNA was more highly expressed in the colon adenocarcinoma lesion than in the adenoma lesions, in the two familial polyposis cases. While MK mRNA was not detected in the normal liver, it became detectable in cirrhotic tissues in 2 of 4 cases, and its expression was increased in the cancerous tissues. Thus, the increase of MK mRNA level is a phenomenon seen in many human gastrointestinal carcinomas. The increased expression of the MK gene in gastric carcinoma was significantly more prominent in well and moderately differentiated adenocarcinomas than in poorly differentiated adenocarcinomas and signet ring cell carcinomas.

Midkine is present in the early stage of cerebral infarct

Expression of midkine (MK), a growth factor with neurotrophic activities, was examined immunohistochemically in experimental cerebral infarct of rats. From postoperative day 1 to day 7 after the onset of infarct, anti-MK immunoreactivity was observed in the surrounding ischemic zone of the infarct but not in the necrotic lesion. The immunoreactive material was identified to be MK by Western blotting. On day 14, anti-MK immunoreactivity became negative. Absence of MK in the normal brain was verified both by immunohistochemical staining and Western blotting. The induced expression of MK is an early event: increased expression of glial fibrillary acidic protein (GFAP), a marker of astrocytes, started on day 4 and continued to day 14. These findings suggest that MK is produced around the site of nerve damage and plays a role as a reparative neurotrophic factor during the early phase of cerebral infarct.

Lectin binding patterns in regenerated rat junctional epithelium

Junctional epithelium (JE) originates from reduced enamel epithelium and is replaced by cells from oral gingival epithelium (OGE) shortly after tooth eruption. Although derived from OGE, cells of JE exhibit both morphologic and functional differences from precursor tissue. We sought to elucidate these differences by investigating histochemical localization of cell surface glycoconjugates in regenerated epithelial cells following gingivectomy in the rat. Distribution and reaction patterns of lectins (Ulex europaeus agglutinin-I, peanut agglutinin, soybean agglutinin, and wheat germ agglutinin) were determined using both light and electron microscopy. We found that although regenerated JE derived from OGE following gingivectomy, its morphologic features as well as histochemical lectin patterns underwent transition to those of non-treated JE. These findings indicate that freshly regenerated JE and primary JE are morphologically and histochemically similar.

Identification of nucleolin as a binding protein for midkine (MK) and heparin-binding growth associated molecule (HB-GAM)

Midkine (MK) is a heparin-binding growth/differentiation factor with a molecular weight of 13 kDa, and is structurally unrelated to fibroblast growth factors (FGF). We studied MK-binding proteins in order to clarify the action mechanism of MK. A 100-kDa protein was identified in PYS-2, 3T3, and L cells as an MK-binding protein by a ligand blot experiment. This MK-binding protein was purified by affinity chromatography on an MK-agarose column followed by SDS polyacrylamide gel electrophoresis. Sequence determination of N-terminal 23 amino acid residues revealed that the MK-binding protein was nucleolin, a major nucleolar protein, which functions as a shuttle protein between the nucleus and cytoplasm and is located also on the cell surface. Heparin-binding growth associated molecule (HB-GAM), which has 50% sequence identity with MK, fused to maltose-binding protein also bound to nucleolin. On the other hand, basic FGF (bFGF) scarcely bound to nucleolin in the absence of heparin, while both MK and bFGF bound weakly to nucleolin in the presence of heparin. Nuclear localization of MK was shown in hemangioma cells by immunohistochemical staining. These findings supported the hypothesis that parts of the MK and HB-GAM are translocated to the nucleus after binding with nucleolin.

Cellular kinetics and lectin distribution in hamster buccal carcinomas

As part of an evaluation of the progression to malignancy, the cellular kinetics of DMBA-induced tumors in the buccal mucosa of hamsters were examined using 5-bromodeoxyuridine (BrdU), peanut agglutinin (PNA), Ulex europaeus agglutinin I (UEA-I) and wheat germ agglutinin (WGA). BrdU-positive cells were localized in the basal layer in both normal and hyperplastic epithelium, whereas they were distributed from the basal to the prickle cell layer in squamous cell carcinoma (SCC). The extent of BrdU labeling increased as the tissues progressed towards malignancy. PNA and UEA-I showed binding only in the prickle cell layer of normal and hyperplastic epithelium, and WGA showed binding mainly in the prickle cell layer. However, in SCC, PNA and UEA-I showed no binding in the prickle cell layer and WGA binding was observed throughout the epithelium. A study of cellular kinetics using BrdU labeling and the lectin binding pattern may be useful in the evaluation of tissue changes on the way to malignancy.

A new family of heparin-binding growth/differentiation factors: increased midkine expression in Wilms' tumor and other human carcinomas

Midkine (MK) and heparin-binding growth-associated molecule/pleiotrophin form a new family of heparin-binding growth/differentiation factors. We studied MK gene expression in human tumors. In normal human reference tissues, MK was highly expressed in the mucosal tissue of the small intestine, moderately in the thyroid, weakly in the tissues of the lung, colon, stomach, kidney, and spleen, and not at all in the liver. All of 6 surgically removed specimens of Wilms' tumor highly expressed MK. Also, a moderate to intense level of MK expression was noted in the majority of surgically removed hepatocellular carcinomas. The MK mRNA level was analyzed in a number of cultured and nude mice-transplanted lines of human tumors. In stomach, colon, pancreatic, lung, and esophageal carcinomas, a moderate to high level of MK expression was found in the majority of them. These results suggest an important role of MK in the development and/or biological behavior of tumors and raised a possibility to use MK as a diagnostic marker. Heparin-binding growth associated molecule/pleiotrophin mRNA was low or scarcely detectable in samples analyzed thus far except for significant levels of the expression that were observed in PA-1 teratocarcinoma cells and in some surgical specimens of Wilms' tumor.

Neuroethological evaluation of audiogenic seizures and audiogenic-like seizures induced by microinjection of bicuculline into the inferior colliculus. I. Effects of midcollicular knife cuts

Audiogenic seizures (AS) are a model of generalized tonic-clonic seizures. The inferior colliculus (IC) and the GABAergic neurotransmission seems to be the most critical site and neurotransmitter system, respectively, of the auditory midbrain involved in AS origin and development. Thus, audiogenic-like seizures are evoked by GABAA antagonists such as bicuculline (BIC). Wistar audiogenic AS resistant (R) rats were sham-transected through the midcollicular line and microinjected with IC bicuculline (BIC; 80 ng/0.2 microliters) (n = 8); transected through the midcollicular line and microinjected with IC saline 0.9% (n = 8); transected through the cortex above the midcollicular line and microinjected with IC BIC (n = 3); transected through the midcollicular line up to 6.0 mm depth and microinjected with IC BIC (80 ng/0.2 microliters or 120 ng/0.3 microliters (n = 8). Wistar AS susceptible (S) rats were submitted to cortical transections (n = 8) and midcollicular transections (n = 7). Animals were studied by means of an ethological method before and after microinjections and/or transections in order to evaluate possible pathways in the AS-like evoked seizures. Bicuculline-evoked seizures were very similar to those evoked by acoustic stimulation, but lacked the tonic-clonic component. No modification in animal behavior was observed in the presence of sound, once the AS-like behavior was initiated. A small percentage of the animals, however, presented procursive behavior which was increased by sound. The IC BIC-evoked patterns were almost totally blocked by midcollicular but not cortical transections. Furthermore, midcollicular but not cortical transections blocked the tonic-clonic component of AS in genetically S animals without modifying the wild running component. These data suggest that the inferior colliculus-superior colliculus connection may be involved in the sensorimotor transduction necessary for AS-like behaviors.

Genomic structure of human midkine (MK), a retinoic acid-responsive growth/differentiation factor

Midkine (MK) is a product of a retinoic acid-responsive gene and a new heparin-binding growth/differentiation factor. The coding sequence of human MK was located on 1.5 kb DNA segment. The structure of the cloned human MK gene was determined and compared with that of the mouse gene. The coding sequence was divided into 4 exons, and each exon and exon-intron boundary was highly homologous to those of the mouse. Furthermore, 170 bases in the upstream region of the putative transcription initiation sites and 3 blocks of 200-350 bases in regions further upstream were highly conserved. These sequences are likely to be involved in developmentally regulated expression of MK.

Spectral analysis of electromyograms for extraocular muscles in normal and ophthalmoplegia cases

Quantitative analysis of electromyograms (EMGs) of the extraocular muscles (EOMs), which contain fast fibers, like all skeletal muscles, but also slow fibers, was carried out in healthy subjects and a patient with external ophthalmoplegia. Interference EMGs of normal extraocular muscles demonstrated a relatively higher power spectrum in the higher frequency domain than those of the biceps brachii (BB). In the case of ophthalmoplegia, the lateral rectus (LR) and medial rectus (MR) muscles demonstrated a power spectrum with a wide ranging distribution up to 2,000 Hz in the early stage of recovery. Conservative treatment led to an improvement in the patient's ocular motility accompanied by a gradual shift of the spectrum towards lower frequencies within 265 days, during which time EMG examinations were performed four times. The results imply that the electrical activity of the slow fibers proper in the extraocular muscles affects the high frequency domain of the power spectrum and that the those fibers synchronously improve with fast fibers.

A new family of heparin-binding factors: strong conservation of midkine (MK) sequences between the human and the mouse

A retinoic acid responsive gene, MK, specifies for a heparin binding factor termed midkine (MK), which is the initial member of a new protein family involved in regulation of growth and differentiation. A cDNA clone of human MK was isolated from a fetal kidney cDNA library. Human MK mRNA was expressed in PA1 teratocarcinoma cells as well as in the kidney. Sequence analysis of the cDNA clone and of a part of the genomic clone yielded the predicted protein sequence of human MK. Human and mouse MK sequences are highly conserved: 87% of amino acids are identical and all amino acid changes are conservative except for an insertion. Comparison of MK and HB-GAM/pleiotrophin (another member of the family) from various species revealed sequences conserved in the family and those specific for each protein.

[Delayed development of binocular function in the long postoperative period of infantile esotropia]

Long-term observation of binocular function was carried out in 30 postoperative cases of infantile esotropia. The period of observation was 5 to 12 years and the targets used for evaluation were deviating angle and stereo acuity. In the successful group, 20 cases out of 30 (67%) achieved a stereo acuity of 60 seconds or better. Among the remainder, partial improvement was seen in 20% and no improvement in 13%. Preexisting amblyopia and ARC improved in the successful group, and the final deviating angle was a mean of 2.3 prism diopter. There were 2 types of cure processes in the successful group. The first group achieved a good binocular function in a relatively early postoperative stage (7 cases), while the second group had delayed development of binocular function over a period of several years (13 cases). The former cases had sufficient orthoptic treatment during admission and the latter showed a gradual improvement of stereo acuity accompanied by good eye position. It has been generally accepted that the rate of binocular function recovery is very poor among cases of infantile esotropia, but our study revealed that skillful orthoptics administered by a selected member of our team over an extended period enabled the achievement of good binocular function in infantile esotropia.

[Evaluation of typical and atypical retinal pigmentary dystrophy by three dimensional analysis (XY plane and time) of averaged electroretinograms]

Retinal functional imaging of patients with typical and atypical retinal pigmentary dystrophies was investigated by three dimensional (XY plane and time) analysis of ERG topography by comparing visual field and fluorescein angiographic findings. The three dimensional analysis revealed that the area of maximal amplitude deviated to the skin area closest to the dominant location of the retinal pigmentary dystrophy (the so-called paradoxical localization). In patients with temporoinferior sectorial retinal pigmentary dystrophy, for example, the maximal amplitude of the a-, b-waves and retinal oscillatory potentials deviated toward the temporoinferior side on the surface topography. These characteristic phenomena of a- and b-waves were found in 60.8% of all patients. Flicker topography with a stimulus frequency of 30 Hz was especially successful in showing the existence and location of paramacular involvement of retinal dystrophy within the area surrounding temporal vascular arcades. The detectability of macular asymmetric involvement was 65.2%. No significant topographic changes were detected in cases in the early stage with no remarkable visual field defects, or in the end stage with remarkable concentric field defects and complicated glaucomatous visual field defects. A comparative study of topographic changes, visual field changes and fluorescein angiographic findings showed that topographic changes in the a-, b-waves, retinal oscillatory potentials and 30Hz flicker components coincided more closely with visual field changes than fluorescein angiographic findings. We proposed that retinal pigmentary dystrophy is not a homogeneous lesion in its progression and believe that the ERG topography method can, by the imaging of dominant locations, detect this disease as well as visual field testing.

[Histopathological and clinical studies of acute necrotizing ulcerative gingivitis and evaluation of treatment]

We report the clinical data, light and electron microscopic findings, therapy and clinical course of three cases treated for acute necrotizing ulcerative gingivitis. The following results were obtained. 1. An ulcerous lesion was observed in the gingiva of all three cases, with case I also showing a depressed lesion in the ulcerous region. 2. In all three cases, the gingival sections displayed ulceration and showed fibrin deposition and neutrophil infiltration on the surface of the ulcerous region. Congested blood vessels and neutrophil infiltration also were observed in the connective tissue beneath the ulcerous region. 3. Many microorganisms, fibrin, cell debris, and enlarged intercellular spaces of the epithelium were seen on the surface on the ulcerous region. 4. Localized treatment, mainly plaque control, was found to be effective clinically and histopathologically.

[Three dimensional analysis (XY plane and time) of averaged electroretinograms for the evaluation of rhegmatogenous retinal detachment and related pathological conditions]

Retinal functional imaging in patients with rhegmatogenous retinal detachment and related pathological conditions was investigated by three dimensional analysis of ERG topography. The three dimensional analysis revealed that the area of maximal amplitude deviated to the skin area closest to the location of the retinal detachment (paradoxical localization). In temporal retinal detachment, for example, the maximal amplitude of the a- and b-waves deviated toward the temporal side on the surface topography. The depth of the retinal detachment was clearly indicated by differential ERG topography. Flicker ERG with a stimulus frequency of 30Hz was especially successful in showing the existence and location of macular detachment within the area surrounding the temporal vascular arcades. ERG topography also indicated the meridional extent of retinal detachment. When there was detachment in two quadrants (e.g., two inferior quadrants), deviation in the surface topography of a- and b-waves appeared in the same quadrants. When detachment expanded into three quadrants, deviation of the amplitude of a- and b-waves closely resembled the extent of the detachment. In addition, however, there was inverse a- and b-wave surface topography on the opposite skin area. When there were two quadrants of retinal detachment, there were two quadrants of inverse a-and b-waves. When there were three quadrants of retinal detachment, there was only one quadrant of inverse a- and b-waves. No inverse a- and b-waves were detected when there was only one quadrant of retinal detachment. In such cases, however, deviation in the surface topography covered three quadrants. These abnormalities were detected in 90.6% of all cases with the retinal detachment disappeared after the retina was reattached. While the buckling procedure and argon laser retinopexy had little effect on the topographical distribution, it was markedly distorted by cryoretinopexy. No remarkable changes in the topographical distribution of a- and b-waves were detected in pathological conditions related to rhegmatogenous retinal detachment. This new method for functional imaging of the retina should be valuable for objective clinical evaluation of retinal detachment.

Short latency visual evoked potentials in functional amblyopia shown using moving topography

The conduction from the eye to the visual cortex through the brainstem was investigated in 43 cases of functional amblyopia by means of moving topography of short latency visual evoked potential (SVEP). Anomaly of the SVEP such as a defect of the main component and remarkable reduction of amplitude was found in cases with severe amblyopia whose visual acuity was less than 0.5. The incidence of abnormal SVEP was recognized in 44% of anisometropic amblyopia (18 cases), 52% of strabismic amblyopia (15 cases), and 50% of deprivation amblyopia (10 cases). The results suggested a reduction of electric activity in the subcortical visual pathway including transmitting nuclei.

Electrophysiological and pathological studies on Creutzfeldt-Jakob disease with retinal involvement

In a case of Creutzfeldt-Jakob disease in a 59-year-old female, multifocal degeneration from the cerebral cortex through the visual pathway to the retina was detected clinically, electrophysiologically, and pathologically. Visual evoked cortical potentials (VECPs) showed a peculiar huge negative wave in the early stage but the amplitude reduced gradually. The a- and b-waves of the ERG were detectable in the final stage. Dynamic topography of VECPs revealed a delay of excitation in the visual cortex in the early stage, but a complete defect of the cortical potential and diminished reactivity of the brain stem were apparent in the later stage. Pathological findings were the spongy degeneration of the cerebral cortex, demyelination of the white matter and the optic pathway, and the degeneration of the nerve fiber layer and ganglion cell layer of the retina.

Average responses evoked by moving grating pattern in the upper, central and lower visual field

Detectable visual evoked potentials were obtained in man by stimulation in the peripheral visual field with a 0.4 cycle/deg vertical grating pattern of 5 degrees arc subtense which moved twice per second horizontally at 415 degrees/sec through an amplitude of 8 degrees arc. These moving grating stimuli were presented to 10 normal subjects, centered 15 degrees above, or centered around, or centered 15 degrees below a fixation mark. The mean latencies (+/- S.D.) of the positive component of the potential evoked by stimuli to the central and 15 degrees eccentricity lower visual field were 114 +/- 17 msec and 104 +/- 20 msec, respectively, while latencies for 15 degrees eccentricity upper visual field stimuli were significantly (p less than 0.001) later with 148 +/- 20 msec.

Studies on visual evoked cortical response by liquid crystal phase difference haploscope: amblyopia and/or strabismus

Visual evoked cortical potentials induced by alternate stimulation of checkerboard pattern with the use of liquid crystal phase difference haploscope were investigated. The synchronization ratio of brain response was determined both in the group of normal binocularity and in the group with binocularity defect. The synchronization ratio of the group of normal binocularity (N = 30) is 100% at 1 Hz x 2, 98.5% +/- 3.9% at 5 Hz x 2, and 83.7% +/- 15.8% at 10 Hz x 2. On the other hand, in the group with binocularity defect, strabismus without amblyopia shows a reduction of the ratio only at the frequency of 10 Hz x 2. Anisometropic amblyopia shows a significant reduction of the ratio at 10 Hz x 2 and strabismus with amblyopia shows a remarkable reduction at 5 Hz x 2 and 10 Hz x 2. As for strabismus with or without latent binocularity, the latter cases show a significant reduction of the synchronization ratio. The reduction of synchronization ratio of VECP seems to have some relationship to the binocularity.

[Bilateral direct injury of oculomotor nerves in craniocerebral trauma-report of a case (author's transl)]

A 46-year-old housewife was admitted to the Kawasaki Hospital soon after traffic accident. She was struck in the right forehead. She was very slightly drowsy but well oriented. Both eyeballs were extremely abducted without any motility. The pupils were bilaterally dilated and equal in size with no response to light. There was a pronounced blephaloptosis on both sides. Another neurological abnormality was a slight right facial weakness. On skull films, a linear fracture in the right temporobasal region was noted but the views of the orbits were normal. A lumbal tap showed a mild subarachnoidal hemorrhage. Three weeks after the trauma, pneumoencephalography showed no abnormal finding. Throughout convalescence, no special treatment was given beyond medication. She improved steadily. Three years after injury, re-examination disclosed that lateral gaze was almost full to either side but upward and downward movements of both eyeballs were limited. In our opinion, the most likely cause of the disability in this case was bilateral direct damage of the oculomotor nerves near the petroclinoid ligament (Grüber).