Negative motor networks: Electric cortical stimulation and diffusion tensor imaging.

INTRODUCTION: This study investigated the networks of Negative motor areas (NMAs) using electric cortical stimulation and diffusion tensor imaging (DTI). METHODS: Twelve patients with intractable focal epilepsy, in which NMAs were identified by electrical cortical stimulation, were enrolled in this study. Electric stimulation at 50Hz was applied to the electrodes during motor tasks to identify the NMAs. DTI was used to identify the subcortical fibers originating from the NMAs found by electrical stimulation. RESULTS: NMAs were found in lateral frontal areas (premotor area (PM) and precentral gyrus) in all 12 patients, in pre-supplementary motor areas (pre-SMAs) in four patients, and in posterior parietal cortices (PPCs) in four. DTI detected fibers connecting to the ipsilateral PMs, PPCs and temporal regions via U-fibers, superior longitudinal fasciculus (SLF), and arcuate fasciculus (AF) from the lateral frontal NMAs. Pre-SMA-NMAs had connections with ipsilateral PMs and contralateral pre-SMAs via the frontal aslant tract and transcallosal commissural fibers, and PPC-NMAs with ipsilateral PMs via SLF and AF. CONCLUSION: This study found the characteristic cortical network of each NMA, and especially revealed new insight of pre-SMA-NMA and PPC NMA. These NMAs might be associated with different mechanism of negative motor response.

Japanese multicenter experience of endoscopic necrosectomy for infected walled-off pancreatic necrosis: The JENIPaN study.

BACKGROUND AND STUDY AIMS: Only a few large cohort studies have evaluated the efficacy and safety of endoscopic necrosectomy for infected walled-off pancreatic necrosis (WOPN). Therefore, a multicenter, large cohort study was conducted to evaluate the efficacy and safety of endoscopic necrosectomy and to examine the procedural details and follow-up after successful endoscopic necrosectomy. PATIENTS AND METHODS: A retrospective review was conducted in 16 leading Japanese institutions for patients who underwent endoscopic necrosectomy for infected WOPN between August 2005 and July 2011. The follow-up data were also reviewed to determine the long-term outcomes of the procedures. RESULTS: Of 57 patients, 43 (75 %) experienced successful resolution after a median of 5 sessions of endoscopic necrosectomy and 21 days of treatment. Complications occurred in 19 patients (33 %) during the treatment period. Six patients died (11 %): two due to multiple organ failure and one patient each from air embolism, splenic aneurysm, hemorrhage from a Mallory - Weiss tear, and an unknown cause. Of 43 patients with successful endoscopic necrosectomy, recurrent cavity formation was observed in three patients during a median follow-up period of 27 months. CONCLUSIONS: Endoscopic necrosectomy can be an effective technique for infected WOPN and requires a relatively short treatment period. However, serious complications can arise, including death. Therefore, patients should be carefully selected, and knowledgeable, skilled, and experienced operators should perform the procedure. Further research into safer technologies is required in order to reduce the associated morbidity and mortality.

Visual perceptual strengths and weaknesses in adults with intellectual disabilities compared with a birth year-matched norm.

BACKGROUND: The ventral and dorsal streams are considered to be the brain substrates of vision for perception and action, respectively. Using the Developmental Test of Visual Perception (DTVP), the current study examined whether visual perceptual strengths and weaknesses in adults with intellectual disabilities (ID) were attributable to the dichotomy of the visual streams. METHOD: In study 1, DTVP performance was compared among mild, moderate and severe adult ID groups; study 2 contrasted adult ID groups with and without Down syndrome (DS). To prevent possible contamination by the Flynn effect, participants were matched by birth year with the norm of the DTVP original edition. RESULTS: Independent of the extent of ID among the three groups in study 1 and the aetiological group difference in study 2, relative strength was found for two DTVP tasks: eye-hand coordination and distinguishing target figures from interference background. Relative weakness was obtained in identifying a figural category. Participants with DS demonstrated exceptional weakness in discerning a target from either mirror-imaged or rotated alternatives, in addition to figural-category detection. CONCLUSIONS: Visual perceptual strengths and weaknesses in persons with ID were difficult to explain on the basis of two visual streams. An interpretation originating in a different research context (e.g. frontal-lobe dysfunction) appears to be required for explaining visual perceptual weaknesses in persons with ID. For persons with DS, strong frontal-lobe dysfunction with atypical lateralisation might be the pathological determinant of visual perceptual weaknesses.

Standard steroid treatment for autoimmune pancreatitis.

OBJECTIVE: To establish an appropriate steroid treatment regimen for autoimmune pancreatitis (AIP). METHODS: A retrospective survey of AIP treatment was conducted in 17 centres in Japan. The main outcome measures were rate of remission and relapse. RESULTS: Of 563 patients with AIP, 459 (82%) received steroid treatment. The remission rate of steroid-treated AIP was 98%, which was significantly higher than that of patients without steroid treatment (74%, 77/104; p<0.001). Steroid treatment was given for obstructive jaundice (60%), abdominal pain (11%), associated extrapancreatic lesions except the biliary duct (11%), and diffuse enlargement of the pancreas (10%). There was no relationship between the period necessary to achieve remission and the initial dose (30 mg/day vs 40 mg/day) of prednisolone. Maintenance steroid treatment was given in 377 (82%) of 459 steroid-treated patients, and steroid treatment was stopped in 104 patients. The relapse rate of patients with AIP on maintenance treatment was 23% (63/273), which was significantly lower than that of patients who stopped maintenance treatment (34%, 35/104; p = 0.048). From the start of steroid treatment, 56% (55/99) relapsed within 1 year and 92% (91/99) relapsed within 3 years. Of the 89 relapsed patients, 83 (93%) received steroid re-treatment, and steroid re-treatment was effective in 97% of them. CONCLUSIONS: The major indication for steroid treatment in AIP is the presence of symptoms. An initial prednisolone dose of 0.6 mg/kg/day, is recommend, which is then reduced to a maintenance dose over a period of 3-6 months. Maintenance treatment with low-dose steroid reduces but dose not eliminate relapses.

Identification of activated T cell receptor gamma delta lymphocytes in the liver of tumor-bearing hosts.

T cell receptor (TcR)gamma delta cells are known to be a minor population of T lymphocytes in the blood (less than 10%) and other peripheral lymphoid organs in healthy donors. We demonstrated here that a large proportion of TcR gamma delta cells, i.e., up to 30% of mononuclear cells (MNC) were detectable in the liver, but not other lymphoid organs of cancer patients. More importantly, the majority of such TcR gamma delta cells (greater than 70%) were shown to be lymphoblastic by electron microscopy. An activation marker of T lymphocytes, Leu-19 (CD56) was also highly expressed on the hepatic TcR gamma delta cells. The possibility of hepatic TcR gamma delta cells being activated was further examined in mice. C3H/He mice injected with syngeneic tumor cells were demonstrated to have an increased number of liver MNC; such MNC showed an ability to proliferate in vitro. These mice eventually had a considerable proportion of TcR gamma delta cells in the liver, showing activation markers, the Ia and LFA-1 antigens. These results suggest that the liver may be an important organ for activation and probably expansion of TcR gamma delta cells especially in tumor bearing hosts.

Cool Temperature-Induced Chlorosis in Rice Plants (II. Effects of Cool Temperature on the Expression of Plastid-Encoded Genes during Shoot Growth in Darkness).

It has been proposed that cool temperature-induced chlorosis (CTIC) in Indica cultivars of rice (Oryza sativa L.) is caused by cell growth and plastid development being impeded at cool temperatures. Since it is well known that the overall rate of transcription of plastid-encoded genes changes dramatically during the early phases of plastid development, in this study we focused on the patterns of expression of these genes. Northern blot analysis revealed that the level of 16S rRNA is decreased in a CTIC-sensitive rice cultivar grown at a cool temperature. The expression of the gene for the [beta] subunit of plasmid RNA polymerase (rpoB) was shown to be somewhat disturbed, particularly in terms of its resuppression under cool conditions. The level of transcripts or proteins of plastid-encoded photosynthetic genes was also decreased in a CTIC-sensitive cultivar at a cool temperature. These results suggest that the temperature-dependent inhibition of the onset of gene expression encoding the transcription/translation apparatus may be primarily involved in the mechanism causing CTIC.

An appropriate in vitro culture condition for the induction of human TCR gamma delta + cells by heat-killed bacteria.

TCR gamma delta + cells proliferated when MNC were stimulated with various heat-killed bacteria. We investigated here the culture conditions for their maximum proliferation. MNC were cultured for 6 days with Streptococcus pyogenes, and for 3 days with T cell mitogens, PHA and anti-CD3 mAb, in medium supplemented with various concentrations (0.05-50%) of human sera. TCR gamma delta + and TCR gamma delta- CD2+3- double negative cells induced by Str. pyogenes required high concentrations of sera (greater than 6%) for their proliferation. Moreover, increased sera (up to 50%) greatly augmented their proliferation. On the other hand, TCR alpha beta + cell proliferation induced by T cell mitogens was supported by a small concentration (even 0.1%) of the sera, and the addition of high concentrations of sera (greater than 6%) somewhat suppressed responses. Similar serum requirement patterns were evident for the induction of cytotoxic cells. These results clearly demonstrated the existence of an appropriate culture condition for the proliferation of TCR gamma delta + cells induced in vitro.

Neuromagnetic localization of N15, the initial cortical response to lip stimulus.

The initial cortical response of the trigeminal somatosensory evoked magnetic fields was measured for electrical stimulation of the lower lip in eleven subjects. The stimulus frequency was 0.7 Hz and stimulus intensity was nine times sensory threshold. The initial contralateral response was detected in 20 hemispheres at a latency of 14.6+/-1.3 ms and was named N15m. The equivalent current dipole of N15m was localized at the posterior bank of the central sulcus with anterior-superior orientation, and inferior to the dipole of N20m for median nerve stimulation.

Auditory evoked magnetic fields in patients with right hemisphere language dominance.

Auditory evoked magnetic fields for pure-tone stimuli were measured in seven subjects with right hemisphere dominance for language using a whole-head magnetoencephalography system linked to magnetic resonance imaging. N100m responses were observed in both hemispheres in five subjects. The N100m response latency to contralateral stimulation was significantly shorter on the right than on the left in all cases. Normal right-handed subjects with left hemisphere dominance showed exactly the same responses. Therefore, the shorter N100m latency in the right hemisphere is independent of the dominant hemisphere for language.

Judging semantic and episodic incongruity: a magnetoencephalographic study.

Evoked magnetic fields over the entire head were measured during a semantic judgment task, in which conditions of the pre-test learning session were manipulated. Subjects learnt related and unrelated category-noun pairs, and were then asked to judge the relationship between category and noun. Unrelated pairs evoked activation around 400 ms in the left temporal area. In addition, newly presented related pairs, of which the categories were used to learn unrelated pairs, also evoked similar activities. Our findings suggest that these activities are not only related to the semantic incongruity between a pair of words as in previous studies, but also to the episodic incongruity between the learning and measurement sessions.

Somatosensory evoked fields in comatose survivors after severe traumatic brain injury.

OBJECTIVE: To evaluate the cortical function quantitatively in patients in the chronic phase of severe traumatic brain injury. METHODS: Thirteen patients with severe traumatic brain injury due to traffic accident followed by persistent consciousness disturbance and disability were studied. Somatosensory evoked magnetic fields (SEFs) for unilateral median nerve stimulation were measured using a whole-head magnetoencephalography system. The latency and electrical current dipole (ECD) moment for the N20m, P30m, N45m and P60m components were calculated and compared with those of 14 age-matched healthy adults. RESULTS: The peak latency of N20m was longer (P<0.05) and those of P30m and N45m were shorter (P<0.01) in the patients than in normal adults. The ECD moment of N20m and P30m was smaller and that of N45m and P60m was larger in the patients than in normal adults (P<0.01). CONCLUSIONS: These results can be explained by the hypothesis that diffuse brain injury induces decreased and delayed input of the somatosensory afferent and compensational amplification of the response in the primary somatosensory cortex. Middle-latency SEFs may be applicable as a cortical functional measure for patients with severe traumatic brain injury.

Middle and long latency peak sources in auditory evoked magnetic fields for tone bursts in humans.

The relative position of the P50m and the N100m sources of the auditory evoked magnetic field remains unclear. Magnetoencephalography was performed in 24 normal subjects. Contralateral P50m to left and right ear stimulus was observed in 21 and 19hemispheres, respectively. Ipsilateral P50m to left and right ear stimulus was observed in 17 and 16hemispheres, respectively. N100m was observed in all subjects for all stimuli. Relative position of the equivalent current dipole of the P50m was 1.0+/-7.6 (mean+/-SD) mm posterior, 2.0+/-5.8mm inferior and 1.8+/-8.0mm medial to the N100m dipole position considering all observations. We suggest that the P50m and N100m sources are colocated in an extended area of the cortex.

Gustatory evoked magnetic fields in humans.

Magnetic fields evoked by taste stimuli of the human tongue were measured over the whole head using a helmet-shaped 64 channel magnetoencephalography system in five normal subjects. The stimuli were 10% glucose and 0.3 M NaCl solutions and distilled water. The most prominent peak (N175m) appearing over the bilateral hemispheres had a latency of 150-210 ms. The N175m sources were located using a two-dipole model in a spherical conducting medium based on the individual head dimensions and superimposed on magnetic resonance images. The N175m dipoles due to 10% glucose and 0.3 M NaCl stimuli were located at the operculum and circum-insular areas in both hemispheres, but those due to distilled water could not be located accurately.

Somatosensory-evoked fields for gingiva, lip, and tongue.

To localize the oral primary somatosensory cortex, we measured somatosensory-evoked fields for the lip, gingiva, and tongue in six healthy subjects. The latency of the first peak of the posterior-oriented current in the contralateral hemisphere was 50.9 +/- 8.3 ms for the gingiva, significantly shorter than those for the lip and tongue peaks. The equivalent current dipole was localized on the central sulcus. The gingival dipole was localized significantly inferior to the lip dipole but not different from the tongue dipole. The moment of the gingival dipole was significantly smaller than that of the lip dipole but not different from that of the tongue dipole. Differences in the above parameters were negligible between the left and right, anterior and posterior, and upper and lower locations within the same organ, except that the dipole location for the anterior upper tongue was significantly inferior to that for the lower tongue.

Profiles of cytokines produced by CD4-positive T lymphocytes stimulated by anti-CD3 antibody in patients with chronic hepatitis C.

Helper T cells (Th) are classified as type 1 (Th1) and type 2 (Th2) according to the cytokines they produce; interferon-gamma is produced by Th1, and interleukin-4 by Th2. We counted the circulating CD4-positive Th cells that produce interferon-gamma or interleukin-4 with an enzyme-linked immunospot assay. CD4-positive T cells isolated from patients with chronic hepatitis B (n = 10), chronic hepatitis C (n = 16), and healthy subjects (n = 10) were stimulated with anti-CD3 antibody in vitro. The number of interferon-gamma-producing Th cells was significantly lower in patients with chronic hepatitis C than in healthy subjects (P = 0.0024), whereas in patients with chronic hepatitis B, the number was similar to that in healthy subjects (P = 0.8530). The number of interleukin-4-producing Th cells was significantly higher in patients with chronic hepatitis C (P = 0.0010) and chronic hepatitis B (P = 0.0089) than in healthy subjects. In chronic hepatitis C, the number of interferon-gamma-producing Th cells was increased after incubation of the cells with interferon-alpha (P = 0.008) or with recombinant interferon-gammala (P = 0.024), but not with interferon-beta (P = 0.051). The number of interleukin-4-producing Th cells was decreased after incubation with interferon-alpha (P = 0.0004), with interferon-beta (P = 0.003), and with recombinant interferon-gammala (P = 0.0004). Changes in the numbers of interferon-gamma- or interleukin-4-producing Th cells in vitro were more evident in sustained responders to interferon therapy than in non-responders. These results suggest that Th2 cells are the predominant cell type in chronic hepatitis C, and that their activity may be suppressed by the administration of interferon.

Neuromagnetic evaluation of cortical auditory function in patients with temporal lobe tumors.

The N100m wave response of the auditory evoked magnetic field originates in the posterior part of the bilateral superior temporal planes for either contra- or ipsilateral ear stimulus. Cortical auditory function was evaluated in 14 patients with temporal lobe tumors using a magnetic resonance (MR) imaging-linked whole-head magnetoencephalography (MEG) system. Before surgery, seven patients had normal N100m latency (within the range of the mean +/- 2 standard deviations of 37 normal volunteers) in both normal hemispheres and in those with lesions, and MR imaging indicated no tumor invasion or edema in the posterior one-third of the superior temporal planes, even when the sylvian fissure was shifted upward due to the mass effect. Seven patients had prolonged N100m latency or absence of N100m in the hemisphere containing the lesion, and the posterior portion of the superior temporal plane was involved by the tumor or perifocal edema. Prolonged N100m latency recovered to the normal range after removal of tumors in two of four patients investigated postoperatively. The MEG system can be used to evaluate cortical auditory function noninvasively before and after surgical treatment of temporal lobe tumors.

Detailed analyses of chloroplast and mitochondrial DNAs from the hybrid plant generated by asymmetric protoplast fusion between radish and cabbage.

In a previous report, intergeneric somatic hybrids between red cabbage (Brassica oleracea L. var.capitata) and radish (Raphanus sativus L. cv. Shougoin) were produced by protoplast fusion. Plant morphology, chromosome number, isozyme patterns, andSma1 cleavage pattern of chloroplast DNA indicated that the hybrid plants have the red cabbage nucleus and the radish chloroplasts. In this report, we analyzed the organization of chloroplast and mitochondrial DNAs from this hybrid using Southern hybridization. The restriction patterns of almost all regions of the chloroplast DNA from the hybrid were similar to that of radish, except for one region near therps16 gene, which encodes the chloroplast ribosomal protein S16. In contrast to chloroplast DNA, the restriction pattern of mitochondrial DNA from the hybrid was quite different from that of the parents.

Intergeneric somatic hybridization of rice (Oryza sativa L.) and barley (Hordeum vulgare L.) by protoplast fusion.

An intergeneric somatic hybrid was obtained upon fusion of protoplasts of rice and barley. Protoplasts isolated from suspension cultures of rice cells were fused by electrofusion with protoplasts that had been isolated from young barley leaves. Some of the resultant calli formed green spots and shoots. Only one shoot formed roots, and it was subsequently successfully transferred to soil in a greenhouse. Its morphology closely resembled that of the parental rice plant. Cytological analysis indicated that the plant had both small chromosomes from rice and large chromosomes from barley. Southern hybridization analysis with a fragment of the tryptophan B (trpB) gene revealed both a rice-specific band and a barley-specific band. Mitochondrial (mt) and chloroplast (cp) DNAs were also analyzed using the same method. The plant was shown to contain novel mitochondrial and chloroplast sequence rearrangements that were not detected in either of the parents.

Non-transcallosal ipsilateral area 3b responses to median nerve stimulus.

We report two patients with left hemisphere lesions who had no normal left hemispheric responses to right median nerve stimulus on magnetoencephalography but displayed right area 3b responses. One patient had suffered a severe left hemispheric contusion and the other left hemispheric infarction. Equivalent current dipoles of these ipsilateral responses were detected on the central sulcus adjacent to the location of the N20m response to left median nerve stimulus. The somatosensory afferent pathway from the hand may extend directly to the ipsilateral area 3b without following the transcallosal pathway in at least part of the population.

[Specific inhibitory effect of hybrid liposomes on the growth of hybridoma cells in vitro].

Remarkably high inhibitory effects of the hybrid liposomes composed of L-alpha-dimyristoyl-phosphatidylcholine (DMPC) and polyoxyethylenealkyl ether (C14(EO)n, n = 6-8 and C12(EO)n, n = 8-12)) on the growth of human lymphoma-human B-lymphocyte hybridoma (HF) cells in vitro were obtained. The hybrid liposomes composed of 90 mol% DMPC/10 mol% C14(EO)n (n = 6-8) or C12(EO)n (n = 8-12) were more fluid as compared with 90 mol% DMPC/10 mol% C14(EO)4 or C12(EO)n (n = 4, 23) hybrid liposomes on the basis of fluorescence polarization measurements. These results suggest that the inhibitory effects of the hybrid liposomes on the growth of HF cells should be related to the membrane fluidity. No toxicity to normal rats in vivo was observed in the experiment using 90 mol% DMPC/10 mol% C14(EO)7 or 90 mol% DMPC/10 mol% C12(EO)12 hybrid liposomes.