Effects of conditioned medium on activities of PAL, CHS, DAHP synthase (DS-Co and DS-Mn) and anthocyanin production in suspension cultures of Fragaria ananassa.

A conditioned medium (CM) prepared from cell suspension cultures of strawberry stimulated anthocyanin synthesis. The effect was significantly (P<0.05) greater than that of synthetic medium (SM), with macronutrient concentrations, carbohydrate concentrations and pH adjusted to those of CM. The activity of 3-deoxy-D-arabino-heptulosonate 7-phosphate (DAHP) synthase (EC 4.1.2.15) (DS-Mn, DS-Co), phenylalanine ammonia-lyase (PAL, EC 4.3.1.5) and chalcone synthase (CHS, EC 2.3.1.74) were monitored in the CM- and SM-cultured cells. PAL and CHS activities were found to increase significantly (P<0.05) in the CM-cultured cells. CHS transcript levels were higher in the CM-cultured cells compared to transcript abundance in SM-cultured cells. There was no significant difference in the DS-Mn and DS-Co activities of cells grown in conditioned or synthetic media.

A case of adenoid cystic carcinoma (ACC) of the breast and review of the utility of preoperative imaging diagnose.

A case of adenoid cystic carcinoma (ACC) of the breast in a 66-year-old woman is reported herein. ACC accounts for about 0.1% of all breast cancers. Our patient presented with a small, elastic and hard mass, measuring 2.0x2.0 cm, between both outer quadrants of the right breast. Although physical examination, ultrasonography and magnetic resonance (MR) mammography suggested a benign tumor, aspiration biopsy cytology (ABC) was performed twice, and the second ABC specimen was evaluated as suspicious for breast carcinoma. Breast conserving surgery with a level II lymph node dissection was subsequently performed. There was no lymph node metastases and estrogen receptor (ER) status was negative. Light microscopy revealed various growth patterns, with the cells showing biphasic cellularity. According to immunohistochemical analyses, CEA, actin and vimentin were positive, S-100 protein was negative, and the cytokeratin reaction was partially positive. Therefore, ACC of the breast was diagnosed. Although ACC of the breast is a rare neoplasm, it should be considered in the differential diagnosis even if various diagnostic imaging studies suggest a benign tumor of the breast. Awareness of this tumor will help prevent misdiagnosis.

Alexia caused by a fusiform or posterior inferior temporal lesion.

We evaluated the alexia and agraphia of three patients with different lesions using Japanese kanji (morphograms) and kana (phonograms) and made a lesion-to-symptom analysis. Patient 1 (pure alexia for both kanji and kana and minor agraphia for kanji after a fusiform lesion) made more paragraphic errors for kanji, whereas patient 2 (alexia with agraphia for kanji after a posterior inferior temporal lesion) showed severe reading and writing disturbances and more agraphic errors for kanji. Brodmann Area 37 was affected in both patients, but in patient 2 the lesion was located lateral to that in patient 1. Patient 3 showed agraphia without alexia after restricted lesion to the angular gyrus. We believe that pure alexia (patient 1) results from a disconnection between the medial fusiform gyrus and posterior inferior temporal area (the lateral fusiform and inferior temporal gyri), whereas alexia with agraphia for kanji (patient 2), corresponding to lexical agraphia in Western countries, results from damage to the posterior inferior temporal area, in which whole-word images of words are thought to be stored. Furthermore, restricted lesion in the angular gyrus (patient 3) does not produce alexia; the alexic symptom of "angular" alexia with agraphia may be the result of damage to the adjacent lateral occipital gyri.

Mitochondrial encephalomyopathy showing prominent microvacuolation and necrosis of intestinal smooth muscle cells: a case diagnosed by rectal biopsy.

A 40-year-old woman who developed intestinal dysmobility was found, at rectal biopsy, to have marked microvacuolation of mucosal muscle layer cells, which corresponded to increased accumulation of abnormal mitochondria. Skeletal muscle biopsy specimens showed ragged-red fibers, vessels strongly reactive for succinic dehydrogenase, and focal deficiency of cytochrome c oxidase. Autopsy performed at the age of 50 revealed prominent accumulation of abnormal mitochondria in the intestinal smooth muscle cells with a mottled distribution of focal necrosis, multiple small cerebral infarcts with diffuse neuronal loss, and rarefaction of the perivascular white matter. Mitochondrial DNA analysis showed a point mutation at position 3243. This case, showing features of both mitochondrial neurogastrointestinal encephalomyopathy and mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), indicates that routine intestinal biopsy can detect mitochondrial encephalomyopathy with gastrointestinal involvement. The main intestinal changes were extensive accumulation of abnormal mitochondria in the leiomyocytes and scattered focal necrosis.

Reversible memory disturbance and intelligence impairment induced by long-term anticholinergic therapy.

It is controversial whether long-term anticholinergic therapy (AC-T) can cause short-term memory disturbance, long-term memory disturbance or intelligence impairment. Ninety patients with Parkinson's disease were examined prospectively to clarify the existence of memory and intelligence impairment induced by long-term AC-T. Neuropsychological tests detected eight patients with at least one of four types of deficits; intelligence impairment in four patients, verbal delayed recall impairment in eight, verbal short-term memory disturbance in five, and verbal long-term memory disturbance in six. Two types of verbal memory disturbance (short-term one and long-term one) appeared with double dissociation, suggesting that there may be an independence between the two types of verbal memory system. Older patients were more prone to suffer from these reversible deficits. Moreover, all of the patients who resumed AC-T, showed recurrence of the deficits acutely. These observations should indicate the tight relation between long-term AC-T and neuropsychological deficits.

[Pure alexia due to a fusiform gyrus lesion].

We present a patient with pure alexia following a hemorrhagic infarction in the left fusiform gyrus. The symptom began with alexia preferentially disturbed for kana, but during the course of recovery slight agraphia for kanji became pronounced. In the earlier phase, alexia was more severe than agraphia and he could write kanji that he could not read. Furthermore, kinesthetic reading was effective. These findings are consistent with the symptoms of pure alexia, although the fact that a writing disturbance for kanji persisted resembles the profile of alexia with agraphia for kanji due to a posterior inferior temporal lesion. Based on the fact that the posterior inferior temporal lesion showed more severe agraphic symptom and more frequent nonresponse writing errors of kanji, and that our patient's lesion was mainly located in the fusiform gyrus that is medial to the inferior temporal gyrus, we believe that alexia occurred when the inferior temporal gyrus was disconnected from the fusiform gyrus, as a result, visual information could not reach the inferior temporal gyrus in which the visual images of individual kanji are stored.

Mechanism of short-term memory and repetition in conduction aphasia and related cognitive disorders: a neuropsychological, audiological and neuroimaging study.

To evaluate the role of the sub-cortical white matter and cortical areas of the supramarginal gyrus in short-term memory impairment (shortened digit or letter span) and repetition difficulty, four patients with conduction aphasia and impaired short-term memory and two patients with only short-term memory impairment were given digit span, letter span, speech audiometry and dichotic listening tests. The results showed that in most of the patients letter span was inferior to digit span and that bilateral ear suppression in the dichotic listening test was observed in two patients with a lesion in the inferior part of the supramarginal gyrus, suggesting that what was affected was phonological information and that the supramarginal gyrus was the storage site. The overlapped lesion of conduction aphasia patients with short-term memory impairment was the periventricular white matter at the upper to middle part of the trigone, while patients with only short-term memory impairment had a lesion in the inferior supramarginal gyrus in common. Thus, damage to the periventricular white matter at the trigone may yield the phonemic paraphasia characteristic of conduction aphasia, while damage to the inferior part of the supramarginal gyrus may result in the impairment of short-term memory. We believe that as a part of the mechanisms of short-term memory and repetition, phonological information is processed in the primary auditory cortex and goes through the periventricular white matter to the inferior part of the supramarginal gyrus and is temporarily stored there.

Cloning genomic DNA encoding apple polyphenol oxidase and comparison of the gene product in Escherichia coli and in apple.

Two PCR-amplified genomic DNA fragments encoding apple (cv. Fuji) polyphenol oxidase (PPO) were cloned and sequenced. A comparison of genomic DNA with cDNAs revealed that the PPOs lacked introns. Both PPO DNAs appear to encode a 66-kDa precursor protein consisting of a 56-kDa mature protein and a N-terminal transit peptide of 10-kDa N-terminal transit peptide. Apple PPO DNA was expressed in Escherichia coli, and the gene product (56 kDa) without a transit peptide was immunochemically detected and was the same size (ca. 65 kDa) as the main PPO of apple fruit by SDS-PAGE.

[A case of spinal hemorrhage associated with abdominal aortic coarctation].

We report a 59-year-old male with abdominal aortic coarctation presented as paraplegia due to spinal hemorrhage caused by the rupture of abnormally dilated spinal artery. In coarctation of aorta, coarctation is usually located in the aortic isthmus which could be the cause of cervical and upper thoracic myelopathy. However, there has been no report of abdominal aortic coarctation with hemorrhagic transverse myelopathy. In this case hemorrhage occurred after surgical treatment and prescribed warfarin may have exaggerated the outcome.

A clinical profile of corticobasal degeneration presenting as primary progressive aphasia.

We report a patient with primary progressive aphasia who first presented with amnesic aphasia that developed over the course of 3 years into nonfluent aphasia with buccofacial apraxia, followed in the next year by cognitive impairment and parkinsonism. Pathological findings were typical for corticobasal degeneration except for the distribution of cortical atrophy. This case suggests that corticobasal degeneration should be included in the differential diagnosis of primary progressive aphasia, especially in association with parkinsonism.

[Tension type headache with special reference to muscle abnormality].

Muscle contraction headache (tension-type headache; MCH) usually begins when a patient is looking down or bending their neck. In the case of MCH patients, EMG activity of the posterior neck muscles at a sitting posture is significantly higher than the controls when the orbito-meatal line is horizontal or bending downward. Comparing with the controls, blood flow of the posterior neck muscle decreases sharply when the head is bent downward. Decrease of the muscle blood flow continues if the muscle is passively contracted. However, in the case of active contraction, blood flow recovers reflexly in 30 seconds. This explains why postural muscle contraction is important. When a patient is ordered to bend her neck down at the orbitomeatal line 30 degrees from horizontal, patient complains of a dull feeling at her posterior neck muscles in 30 seconds. In two minutes dull headache appears at the occipital area, soon becoming more intense and spreading to the forehead and temporal area. Once she looks up, muscle contraction of the neck disappears though she still feels headache. After the local anesthesia is applied to the occipital tender point, her headache disappears completely. From this experiment, MCH is a referred pain from occipital tender point which is the insertion point of occipital neck muscles. Patients with poor stability of cervical bone, and relatively heavy head weight compared with their neck are susceptible to MCH. Psychological stress decreases blood flow of the muscle and aggravates ischemic muscle contraction. Other risk factors include hypotension, anemia, and weak muscle power.

Positron emission tomography of reversible intellectual impairment induced by long-term anticholinergic therapy.

Long-term oral anticholinergic (AC) therapy can occasionally produce intellectual impairment. We investigated a patient with Parkinson's disease accompanied by intellectual impairment induced by long-term AC therapy. The intellectual impairment of the patient disappeared after cessation of AC therapy. Positron emission tomography (PET), during and after long-term oral AC therapy, revealed that it causes bilateral diffuse decrease of glucose metabolism in the cortex, basal ganglia, thalamus, hippocampus and cerebellum. Cessation of the therapy resulted in diffuse increase of glucose metabolism in all of the above regions. Cranial CT and magnetic resonance imaging (MRI) showed no abnormalities. Our results suggest that long-term AC therapy causes reversible bilateral diffuse glucose hypometabolism.

Mexiletine for painful alcoholic neuropathy.

Five patients suffering from painful alcoholic neuropathy showed severe painful sensory disturbance in their extremities. Although their pain was not ameliorated by the typical usual analgesic agents, oral mexiletine (MX) therapy was remarkably effective for the pain (especially tingling and aching sensation) without major side effects. This study indicated that the minimum effective dose was 300 mg per day and the effective concentration of MX in plasma was 0.66 +/- 0.15 micrograms/ml in these patients. Thus, oral MX therapy can be a reliable treatment for pain in alcoholic neuropathy.

Elevated serum interleukin-6 in POEMS syndrome reflects the activity of the disease.

In patients with POEMS syndrome, which often accompanies plasma cell dyscrasia, the roles of interleukin-6 (IL-6) and other acute phase cytokines are unknown. Serum IL-6, interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) were measured by the enzyme-linked immunosorbent assay technique in 16 patients with POEMS syndrome and in patients with other neurological diseases (OND) as control. Serum IL-6 was more frequently detected and higher in active POEMS than in stable POEMS or in OND patients. No sample was positive for IL-1 beta. TNF-alpha was positive in 3 out of 7 active POEMS patients, but its significance was not definite. Serum IL-6 levels in POEMS patients reflected the disease activity but not the severity of accompanying plasma cell dyscrasia.

[Neurosarcoidosis].

Frequency of nervous involvement in patients with sarcoidosis is 6.4% in Japan. Among them, half of the neurosarcoidosis patient shows central nervous involvement. A classification of neurosarcoidosis was made as follows; A) central nervous system involvement, 1) granulomatous meningoencephalitis, 2) intracerebral granuloma, 3) hydrocephalus, 4) hypothalamus/pituitary involvement, B) peripheral nervous system involvement, 1) cranial nerve involvement, 2) spinal nerve involvement. A criteria of neurosarcoidosis was presented; A) definite neurosarcoidosis (pathology proven) a case in which nervous involvement of sarcoidosis was proven pathologically, B) probable neurosarcoidosis (laboratory proven) a case in which laboratory data or radiological exam. was proven, C) possible neurosarcoidosis (clinical sign only) sarcoidosis patient with neurological sign. Autopsy cases demonstrated multiple cranial nerves involvement without any cranial nerve symptoms. Spinal and cranial nerve involvement seems to be much more frequent than it is believed.

Naming difficulties in alexia with agraphia for kanji after a left posterior inferior temporal lesion.

The case is described of a patient with alexia and agraphia for kanji, and severe anomia after a subcortical haemorrhage in the left posterior inferior temporal area. Magnetic resonance imaging at four months after onset showed a lesion in the inferior temporal and fusiform gyri, extending from the temporo-occipital junction toward the anterior third of the temporal lobe. Comparison with other reported cases of alexia with agraphia and anomia made it clear that when accompanied by severe anomia, the lesions extended either forward to the anterior part of the middle temporal gyrus or medially to the parahippocampal gyrus. It is suggested that the disconnection of association fibres between the parahippocampal, fusiform, middle, and inferior temporal gyri, especially between the parahippocampal gyrus and the other temporal gyri, or the cortical damage to the posterior part of these gyri is essential for the production of anomia.

[Gastric acid secretion and absorption of levodopa in patients with Parkinson's disease--the effect of supplement therapy to gastric acid].

Since an oral regimen of levodopa has been instituted for treatment of Parkinson's disease, its absorption and metabolism has been well demonstrated. However, its chemical characteristics of high solubility in acid solution and low solubility in water have not been well known. We paid attention to this characteristic and studied the relationship between its absorption and gastric acid secretion in 38 patients with Parkinson's disease who became refractory to therapy of levodopa. We measured the pH and amount of collected fasting gastric juice. Gastric acid secretion was decreased in 22 patients (58%). In ten of these 22 patients, 30 ml of lemon juice was prescribed in every administration of levodopa as a supplement to gastric acid for two weeks. Increases of L-dopa concentration after 60 min. and 180 min. were observed after lemon juice supplement therapy. Among the Parkinson symptoms, rigidity, akinesia, and small step gait were improved in every case except one patient who showed decrease of L-dopa concentration at 180 minutes. However, improvement of tremor was less remarkable. We consider this supplement therapy to gastric acid is one of the effective and useful methods in the management of Parkinson's disease.

Axial myoclonus mediated by the propriospinal tract: a case report.

We describe a patient with axial myoclonus. Myoclonus first occurred in the upper abdominal muscle and spread up to the neck muscle and down to the lower abdominal muscle. Physiological studies of the jerks revealed that the myoclonus arose in the thoracic spinal cord and spread slowly up and down the spinal cord at about 3 m/s. We conclude that the myoclonus is mediated by the propriospinal tract.

Giant somatosensory evoked magnetic field in patients with myoclonus epilepsy.

We investigated somatosensory evoked magnetic fields (SEFs) and somatosensory evoked potentials (SEPs) in patients with myoclonus epilepsy. The median nerve was stimulated at the wrist, and responses were recorded over the contralateral hemisphere. The source of the enlarged cortical component of the giant SEF was localized on the post-central sensory cortex. The P1 component of the giant cortical response was composed mainly of a tangentially oriented dipole at area 3b. This is the first magnetoencephalographic analysis of an abnormally enlarged somatosensory cortical response.