Mu rhythm: clinical assessment of the atypical type]

Of 5,218 patients who received EEG examination at our laboratory during a 9-month period in 1989, 241 showed the 7-13 Hz arch-shaped activity originating from over the Rolandic area known as mu rhythm. These subjects were divided into two groups as follows: Group 1, 171 subjects showing typical mu rhythm, i.e., recorded during wakefulness and not affected by visual stimulation but blocked voluntary movements or tactile stimuli; and, Group 2, 70 subjects showing atypical mu rhythm, i.e., accentuated or activated by drowsiness, photic stimuli, or hyperventilation. No difference between the two groups was found with regard to frequency, amplitude or origin of the mu rhythm. Age distribution for Group 1 showed a peak between the ages of 6 and 15 (67.5%), while that for Group 2 peaked between the ages of 11 and 15 (35.7%) considering high incidence in older age range. There was no significant difference between the two groups in regard to gender. Although both groups showed a high incidence of epilepsy, Group 2 showed higher incidence of intractable epilepsy (p less than 0.05), as well as of severe intracranial trauma and of organic brain disease. On EEG recorded among epileptic patients, paroxysmal discharge was more frequent in Group 2 (p less than 0.01), although no other difference between the two groups was observed. Atypical mu rhythm may indicate more severe epilepsy, and careful observation of patients with atypical mu rhythm is recommended.     

Frontal spindle activity that appears in conjunction with nontraumatic diffuse encephalopathy.

This peculiar 11-14 Hz spindle activity appears predominantly in the frontal area, and was observed in eight patients with impaired consciousness caused by nontraumatic diffuse encephalopathy. Characteristic of this frontal spindle activity is its transience and accordance with changes in the arousal level of the patient. When the degree of impaired consciousness in the patient was minimal and clinically not very apparent, this spindle activity appeared during light drowsiness. In lethargic patients, it was observed when the patient's level of consciousness rose (e.g. immediately after opening and closing the eyes). These frontal spindles disappeared at the onset of Stage 2 sleep, when normal physiologic spindle waves that are dominant in the vertex area appeared. A paroxysmal discharge was sometimes recorded in association with the frontal spindle activity and it disappeared at about the same time as these spindles. The prognosis was satisfactory for all patients in whom frontal spindle activity was observed; its correlation to spindle coma is also studied.     

Release of endogenous excitatory amino acids from ON-type bipolar cells isolated from the goldfish retina.

Excitatory amino acids are presumed to be the transmitter of retinal bipolar cells. However, one of the essential criteria for the identification of the transmitter, its release from the cells upon depolarization, has not been demonstrated. This article examines the release of endogenous excitatory amino acids from bipolar cells and correlates this release with the influx of Ca2+. Bipolar cells with a large, bulblike axon terminal (ON-type cells with mixed inputs from rods and cones) were enzymatically isolated from the goldfish retina. Horizontal cells dissociated from the catfish retina were used as a probe of excitatory amino acids, because these cells can detect submicromolar concentrations of L-glutamate with high selectivity. An isolated bipolar cell was closely apposed to a dissociated horizontal cell, and each cell was voltage clamped by a patch pipette in the whole-cell clamp configuration. When the bipolar cell was depolarized from -60 mV to a potential more positive than -40 mV using a 500-msec voltage pulse, an outward current (greater than 20 pA) was recorded from the apposed horizontal cell, which was maintained at +40 mV. The reversal potential of the current induced by the substance released from bipolar cells (Irs) was close to 0 mV and was almost identical to the responses evoked with ionophoretically applied L-glutamate. Both reversal potentials were shifted to the same, more negative value when the external Na+ was replaced with choline. Furthermore, the Irs was suppressed reversibly by the application of kynurenic acid, a glutamate antagonist. When the Ca current (ICa) of the bipolar cell was blocked by Cd2+, the Irs also disappeared. The peak amplitude of Irs was closely related to that of the ICa. We conclude that mixed rod/cone ON-type bipolar cells of the goldfish retina release an endogenous excitatory amino acid or a closely related compound in a Ca(2+)-dependent manner.     

Analysis of DNA copy number aberrations in hepatitis C virus-associated hepatocellular carcinomas by conventional CGH and array CGH.

To clarify the genetic aberrations involved in the development and progression of hepatitis C virus-associated hepatocellular carcinoma (HCV-HCC), we investigated DNA copy number aberrations (DCNAs) in 19 surgically resected HCCs by conventional CGH and array CGH. Conventional CGH revealed that increases of DNA copy number were frequent at 1q (79% of the cases), 8q (37%), 6p (32%), and 10p (32%) and that decreases were frequent at 17p (79%), 16q (58%), 4q (53%), 13q (42%), 10q (37%), 1p (32%), and 8p (32%). In general, genes that showed DCNAs by array CGH were usually located in chromosomal regions with DCNAs detected by conventional CGH analysis. Increases in copy numbers of the LAMC2, TGFB2, and AKT3 genes (located on 1q) and decreases in copy numbers of FGR/SRC2 and CYLD (located on 1p and 16q, respectively) were observed in more than 30% of tumors, including small, well-differentiated carcinomas. These findings suggest that these genes are associated with the development of HCV-HCC. Increases of MOS, MYC, EXT1, and PTK2 (located on 8q) were detected exclusively in moderately and poorly differentiated tumors, suggesting that these alterations contribute to tumor progression. In conclusion, chromosomal and array CGH technologies allow identification of genes involved in the development and progression of HCV-HCC.     

A case of cystic lymphangioma grown in subcutaneous tissue of the pubis

A 37-year-old man visited our hospital with the chief complaint of a painless mass in subcutaneous tissue of the pubis. We extirpated the localized cyst 2.5 x 4 cm in size. Histological diagnosis was cystic lymphangioma without malignant findings. We reviewed the literature on lymphangioma, a rare disease seldom seen in urological fields.     

Clinical studies on a newly devised amino acid solution for neonates

In 97 neonates receiving total parenteral nutrition in the postoperative period, clinical assessment was made for a newly devised amino acid solution (PF-I-III) from the standpoint of plasma amino acid profile and nutritional effect. These amino acid solutions prepared are characterized by the high concentration of branched-chain amino acids up to 40%, increased arginine and decreased glycine, phenylalanine and methionine as compared with commercially available solutions. In the PF group, each amino acid was kept within the range of standard value. Correlation between plasma amino acid profiles and the dose of each amino acid administered was obtained, from which minimum, standard, and maximum doses for each amino acid was determined. Based on these values, we proposed new formula for neonates which elicits no abnormal plasma amino acid pattern even when amino acids are administered at the dosage level of 1.5-2.5 g/kg/day.