An autopsy case of argyrophilic grain dementia with abundant neurofibrillary tangles]

We reported an autopsy case of "senile dementia" showing neuropathologically abundant neurofibrillary tangles(NFT) and argyrophilic grains(AG) without senile plaques. A Japanese woman developed memory disturbance when she was 70 years old. The patient was hospitalized at age 80 and a cranial CT scan revealed bilateral mild atrophy of the temporal lobes and mild enlargement of the lateral ventricle, especially in the inferior horn. She died at the age of 80. Autopsy showed that her brain weighted 1220 g. Numerous NFT were found in the entorhinal (trans-entorhinal) region, subiculm, CA1-CA4, dentate gyrus, amygdala, nucleus basalis of Meynert, substantia nigra, and locus coeruleus. Furthermore, numerous AG were seen in the temporal lobe(T3, T4), amygdala, prominently in the basolateral nuclei. Obvious neuronal loss with gliosis was noted in the temporal lobes, including the hipocampal regions. Few senile plaques was detected in temporal lobe(T4). Sarkosyl-insoluble tau extracted from the temporal lobe consisted predominantly of four-repeat tau isoforms. To our knowledge, this is the first report of argyrophilic grain dementia complicated with tangle only dementia.     

Cognitive conditions of pathologically confirmed dementia with Lewy bodies and Parkinson's disease with dementia

The relationship between dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD) has been insufficiently described, and it is still problematic. Twenty-nine cases of DLB and 10 cases of PDD were investigated in the present study. DLB cases disclosed a significantly older disease onset and shorter disease duration than PDD cases (p<0.01 each). However, they showed no significant difference in dementia onset or dementia duration (p>0.05 each). Motor symptoms (parkinsonism) were suspected as the cause of the younger disease onset in PDD cases. Compared with 10 age-matched cases of definite Alzheimer's disease, both 19 DLB cases and 6 PDD cases had significantly better scores in the final test of mini-mental state examination (MMSE) and revised version of Hasegawa's Dementia Scale (HDSR) within 12 months before death, although no significant differences between DLB and PDD were indicated. DLB and PDD were suspected to show cognitive impairment of similar severity in the terminal stage. They would thus be difficult to classify as completely different entities.     

The parents' assessment and needs for home mechanical ventilation in patients with pediatric neurological disorders

Parents' of patients with pediatric neurological disorders were sent a questionnaire, on their assessment and needs for home mechanical ventilation (HMV). Nine of 12 enrolled families responded. Respirator troubles were handled by a contracted HMV company. Decreased SpO2 levels and endotracheal bleeding were cared by family members under telephone instructions of doctors, though they felt anxious about dealing the problems. The mothers felt happy to live with their children by virtue of HMV, however, they had strong stress about the management of emergency care and medical care technique. They also felt very tired physically, but refreshed by being free from daily HMV care for a short time and enjoying their own time. The parents were not satisfied with the present house facilities and education system. They evaluated the induction of HMV positively but were most anxious for a better home care nursing system, doctors responding to a house call, more information on HMV, reduction of their anxieties and fatigue, and improvement of economical and educational environments.     

An open trial of risperidone in autistic children

Clinical effects of risperidone were evaluated in 9 young autistic children under informed consent of their parents. The patients were evaluated by the Children's Behavioral Checklist and Rutter's Autistic Behavioral Rating Scale. After the administration, two subjects (playing and adaptation to change) of the Children's Behavioral Checklist and four (anomalous autistic behavior, destructive behavior, developmental problem and activity level) of the Rutter's Autistic Behavioral Rating Scale were improved significantly. There were no serious side effects such as extrapyramidal symptoms except minor adverse effects including sedation, depression, increased appetite and constipation. Risperidone might be effective for serious behavioral disturbances in young autistic children.     

Urokinase-type plasminogen activator is activated in stratum corneum after barrier disruption

The plasminogen/plasmin system in epidermis is thought to be the major protease involved in the delay of barrier recovery. However, little is known about the mechanism through which this system is activated. In order to clarify this mechanism, we first determined the distribution of proteolytic activity by using in situ zymography. As a result, plasminogen-activator activity was found to be present in the stratum corneum (SC) after barrier disruption. Next, SC subjected to repeated barrier disruption was collected to identify the protease. The protease was identified as urokinase-type plasminogen activator, because flybrinolytic activity of the collected SC was abolished by addition of anti-urokinase antibody. Urokinase activation in SC was confirmed by means of an in vitro assay, in which the precursor of urokinase (pro-uPA) became active after incubation with the insoluble component of SC homogenate. These findings indicated that urokinase-type plasminogen activator is activated in SC after barrier disruption and this activation might trigger the plasminogen/plasmin system in the epidermis.     

Enhanced expression of vascular endothelial growth factor by periodontal pathogens in gingival fibroblasts

Vascular endothelial growth factor (VEGF) has recently attracted attention as a potent inducer of vascular permeability and angiogenesis. Aberrant angiogenesis is often associated with lesion formation in chronic periodontitis. The aim of the present study was to investigate the properties of VEGF expression in human gingival fibroblasts (HGF) culture. HGF were stimulated with lipopolysaccharide (LPS), vesicle (Ve) and outer membrane protein (OMP) from Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. HGF constitutively produced VEGF and levels were significantly enhanced (P < 0.01) by stimulation with Ve and OMP from A. actinomycetemcomitans and P. gingivalis at concentrations of 10 microg/ml or higher. On the other hand, VEGF levels were not increased by LPS stimulation. VEGF mRNA expression was also observed in Ve- and OMP-stimulated HGF. A vascular permeability enhancement (VPE) assay was performed using guinea pigs to ascertain whether supernatant from cultures of Ve- and OMP-stimulated HGF enhance vascular permeability in vivo. Supernatant from cultures of Ve- and OMP-stimulated HGF strongly induced VPE. This was markedly suppressed upon simultaneous injection of anti-VEGF polyclonal antibodies with the supernatant. Heating and protease treatment of the stimulants reduced the VEGF enhancing levels in Ve and OMP in vitro. These results suggest that Ve and OMP may be crucial heat-labile and protease-sensitive components of periodontal pathogens that enhance VEGF expression. In addition, VEGF might be associated with the etiology of periodontitis in its early stages according to neovascularization stimulated by periodontal pathogens causing swelling and edema.     

Effect of surface treatment and cement maturation on the bond strength of resin-modified glass ionomers to dentin

This study investigated the effect of surface treatment and cement maturation on the bond strength of resin-modified glass ionomer cements (RMGICs) to dentin. Forty-two freshly extracted premolars were embedded and horizontally sectioned at a level 2 mm from the central fossa to obtain a flat dentin surface. The premolars were randomly divided into three groups of 14 teeth and treated as follows: Group 1 (control)--no surface treatment, Group 2--conditioned with 20% polyacrylic acid for 10 seconds and Group 3--etched with 37% phosphoric acid for 15 seconds. RMGIC (Fuji II LC, GC) columns (3 mm diameter; 2 mm high) were applied to the dentin surface and shear bond testing was carried out after one week (n = 7) and one month (n = 7) storage in distilled water at 37 degrees C using an Instron Universal testing machine with a cross-head speed of 0.6 mm/minute. The failure mode was examined at 40x magnification and scored with imaging software. The results were analyzed using ANOVA/Scheffe's post-hoc test and Kruskal-Wallis/Mann-Whitney test at a significance level of 0.05. The effect of surface treatment on shear bond strength to dentin was time dependent. Mean strengths ranged from 3.16 to 5.81 MPa at one week and 5.00 to 14.95 MPa at one month. Although no significant difference in strengths was observed among the groups at one week, significant differences (Group 2 > Group 1 > Group 3) were detected at one month. At one month, conditioned and untreated specimens exhibited significantly less adhesive failure than etched specimens.