Effect of mood stabilizing agents on agonist-induced calcium mobilization in human platelets

The effect of mood stabilizing agents such as lithium, carbamazepine, valproic acid and clonazepam on serotonin(5-HT)- or thrombin-induced intracellular calcium (Ca) mobilization was studied in the platelets of healthy subjects using the fluorescent Ca indicator fura-2. After incubating platelet-rich plasma with these drugs for one or four hours, there was no significant difference in either basal Ca2+ concentration or 5-HT-stimulated Ca response between each agent treatment and control. 5-HT- or thrombin-induced Ca mobilization was not altered by four weeks of lithium carbonate administration in healthy volunteers. These results indicate that these mood stabilizers fail to affect the agonist-stimulated intracellular Ca mobilizing pathway either in vitro or ex vivo in the platelets of healthy subjects.

Time course of changes in phospholipid in cardiac mitochondria from rats recovering from prolonged swimming

The time course of the recovery of cardiac mitochondrial phospholipids was investigated in rats subjected to a 3 hour loaded swim. The 3 hour swim caused a 50% reduction in mitochondrial phospholipids compared with the level in sedentary controls. During the first 12 hours of the recovery period, phospholipids tended to increase but fell again before reaching control values by 120 hours after the swim ended. Phospholipid recovery in microsomes was completed in 12 hours. Total mRNA in cardiac tissue decreased by about 15% in rats subjected to a 3 hour loaded swim but recovered to control levels in the first 12 hours of the sedentary recovery period. Thus, fluctuations in cardiac mitochondrial phospholipids do not parallel the changes in total mRNA in cardiac tissue.

Phosphorylation of farnesol by a cell-free system from Botryococcus braunii

Farnesol was incorporated into squalene as well as botryococcenes when the alcohol was fed to the culture of Botryococcus braunii B race strain. In in vitro experiments with a 10,000 x g supernatant of cell homogenate, squalene was synthesized from farnesyl diphosphate in the presence of NADPH or NADH, but botryococcenes were not synthesized under the same conditions. A 100,000 x g pelet fraction was able to phosphorylate farnesol to give its mono- and diphosphate esters in a CTP dependent manner.

Effects of repeated administration of a high dose of methamphetamine on dopamine and glutamate release in rat striatum and nucleus accumbens

We examined effects of a high dose of methamphetamine (MA) (4.02 mg free base/kg, s.c., at 2-h intervals, 4 injections) on extracellular concentrations of monoamines such as dopamine (DA), dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA), and 5-hydroxyindoleacetic acid (5-HIAA) and those of glutamate and other several amino acids in rat striatum (ST) and nucleus accumbens (NA) using in vivo microdialysis. Five days after the microdialysis, tissue concentrations of monoamines were measured. The toxic dose of MA markedly increased extracellular concentrations of DA, and decreased those of DOPAC, HVA and 5-HIAA in both ST and NA. Magnitude of the increase in DA release was not different between ST and NA. Extracellular concentrations of glutamate showed a gradual increase in ST, but not in NA, while other amino acids showed no changes in both ST and NA. Tissue concentrations of serotonin (5-HT) and 5-HIAA were decreased to 43-58% of control values in both ST and NA, whereas those of DA, DOPAC and HVA showed 43-54% decrease in ST but no changes in NA. These data suggest that the marked increase of DA release is not directly related to the MA-induced dopaminergic neurotoxicity. The increase in glutamate release found only in ST may be related to the dopaminergic damage in ST. It may be that enhanced release in DA and glutamate act synergistically to cause the dopaminergic neurotoxicity in ST. However, enhancement in glutamate release did not appear to be essential for the MA-induced serotonergic neurotoxicity.

Different NH2-terminal form with 12 additional residues of alpha 2-plasmin inhibitor from human plasma and culture media of Hep G2 cells

alpha 2-Plasmin inhibitor (alpha 2PI) was purified from plasma or from the culture media of Hep G2 cells by one-step immunoaffinity chromatography procedure. Majority of alpha 2PI purified from plasma was the previously recognized plasma alpha 2PI with NH2-terminal Asn (Asn-alpha 2PI), whereas majority of alpha 2PI purified from the culture media was retaining the "pro" peptide of 12 amino acids with NH2-terminal Met (Met-alpha 2PI). When Hep G2 cells were cultured in serum-free media, the alpha 2PI secreted to the media was totally in a form of Met-alpha 2PI. Incubation of Met-alpha 2PI with human plasma induced the complete conversion of Met-alpha 2PI to Asn-alpha 2PI. The results indicate that alpha 2PI is synthesized and secreted from liver cells as Met-alpha 2PI and Met-alpha 2PI is converted to Asn-alpha 2PI by proteolytic cleavage in plasma during the circulation.

Microdynamics of the phospholipid bilayer in cardiomyopathic hamster heart cell membrane

To investigate the microdynamics and the structural architecture of the membrane phospholipid bilayer during the course of cardiomyopathy, membrane fractions were prepared from hearts of cardiomyopathic Syrian hamsters (BIO 14.6) aged 4, 18 and 31 weeks and compared with age-matched control hamsters (F1b). Membrane cholesterol, phospholipids and phospholipid fatty acids were measured by thin-layer chromatography, gas-liquid chromatography and high performance liquid chromatography. Microdynamics of the phospholipid bilayer were determined by a nanosecond fluorometer using pulsed excitation of a fluorescent probe, diphenyl-hexatriene. At the age of 4 weeks, there was no difference in lipid compositions and microdynamics between the BIO 14.6 and F1b. At the age of 18 weeks, saturated fatty acids, 18:0 and 22:0 increased and 20:0, 20:2 and 32:4 decreased in the BIO 14.6. At the age of 31 weeks, adding to the above changes in phospholipid fatty acids, unsaturated fatty acids 20:4 and 22:6 decreased, moreover membrane phospholipids, especially phosphatidylinositol and phosphatidylethanolamine significantly decreased. The viscosity and the wobbling angle of phospholipid molecules were decreased significantly. We have previously demonstrated that intracellular Ca2+ accumulation might be responsible for the pathogenesis of cardiomyopathy. Thus, we conclude that cardiomyopathic membrane may alter its structure and function with age. These alterations in cell membranes might be involved in the cardiac hypertrophy and dysfunction through impaired Ca2+ handling in cardiomyopathic hamsters.

[The indications and limitations of open heart surgery without homologous blood transfusion in children and infants]

Open heart surgery without homologous blood transfusion in adults is a generalized method, but not in children and infants. We have attempted to perform open heart surgery without blood transfusion in small children and infants, and report here our experiences and ideas in this regard. The number of open heart surgeries we performed on patients less than 15 years old was 117 from April 1988 to April 1993. In 57 patients among them we attempted open heart surgery with bloodless priming in the cardiopulmonary bypass circuit. Eleven patients were given blood transfusion during the operation or the post-operative period. Another 46 discharged without blood transfusion. From April 1988 to December 1990 (the earlier period) we used the conventional style cardio-pulmonary bypass circuit with gravity venous drainage for 12 patients undergoing open heart surgery without blood transfusion. The lowest weight of these patients was 13 kg and the main diseases were ASD and mild VSD. From January 1991 to April 1993 (the later period), we used the new type cardio-pulmonary bypass circuit with lower priming volume for 34 patients undergoing open heart surgery without blood transfusion. The youngest age was 7 months and the lowest weight was 6.5 kg. The diseases were ASD (9), mild VSD and VSD/PH (15), TOF (6) and other (4). In the new cardiopulmonary bypass system, the venous reservoir and cardiotomy sucker are given negative pressure ((-10)-(-40) mmHg) with a vacuum not a pump, and only one roller pump is used for the arterial pump.(ABSTRACT TRUNCATED AT 250 WORDS)

Serotonin-induced platelet intracellular calcium mobilization in depressed patients

Serotonin(5-HT)-stimulated intracellular calcium(Ca) mobilization was measured in the platelets of depressed patients to assess 5-HT2 receptor function. The 5-HT-induced Ca response was significantly higher in unmedicated patients with bipolar depression and melancholic major depression than in those with non-melancholic major depression and normal controls. The enhanced Ca response to 5-HT failed to correlate with severity of depressive symptoms. In patients with bipolar disorder and melancholic major depression, there was no significant difference in 5-HT-stimulated Ca response between the unmedicated group and those in remission. These results suggest that 5-HT2 receptor function is increased in some types of depression, and raise the possibility that the enhanced Ca response to 5-HT may be trait dependent rather than state dependent.

Blood-borne macromolecule induces FGF receptor gene expression after focal ischemia

We have detected fibroblast growth factor receptor (FGFR) gene expression in the focal ischemia model. The FGFR gene expression in neurons can be explained by neuronal network disturbances, but the mechanism of astroglial gene expression remains uncertain. We speculated that blood-borne edema fluid may activate gene expression of astroglias. To prove this hypothesis, we compared the pattern's of gene expression of FGFR and distribution of edema fluid by using serial tissue sections of the middle cerebral artery (MCA) ischemia. The left MCA of twenty-four male Wistar rats were occluded, and sacrificed 1, 3, 4, 7 and 14 days later by transcardiac perfusion and fixation. The tissues were sliced thinly to 14 microns sections. Part of the tissue sections was used for in situ hybridization for rat FGFR with [35S]labeled RNA probes. The other part of the sections was used for immunostaining for albumin, immunoglobulin G (IgG) and IgM. The FGFR mRNA expression was evident in the lesion-side hemisphere. In the cortex, neurons mainly expressed FGFR gene in the cortex, whereas astroglias and capillary endothelium expressed FGFR in the corpus callosum and internal capsule. The albumin distributed cortex and white matter of the lesion-side and it extended to the contralateral side. The IgG distributed mainly in the lesion-side white matter, and in part extended to the contralateral side. The IgM only distribute to the infarcted area. When we compared topographical distribution of FGFR in the white matter and pattern of albumin, IgG and IgM distribution, pattern of IgG distribution correlated well to the area of FGFR expression.(ABSTRACT TRUNCATED AT 250 WORDS)

Pharmacological characterization of epinephrine-stimulated GTPase activity in human platelet membranes

The alpha 2-adrenergic receptor-mediated stimulation of GTPase activity was investigated in human platelet membranes. The stimulatory effect of (-)-epinephrine was strictly dependent on Mg2+ and derived from a high-affinity GTPase activation. (-)-Epinephrine and (-)-norepinephrine stimulated GTPase activity in a concentration-dependent manner with EC50 values of 200 and 600 nM, respectively. These effects were stereospecific, since (+/-)-epinephrine, (+/-)-norepinephrine, and (+)-epinephrine were less potent in stimulating the enzyme activity with EC50 values of 4, 1 and 3 microM, respectively. Thrombin also stimulated GTPase activity concentration dependently with an EC50 value of 0.02 U/mL. The maximal effects of (-)-epinephrine, (-)-norepinephrine, and thrombin were not additive in any combination. Clonidine did not stimulate GTPase activity, whereas another synthetic alpha 2-adrenergic agonist, p-aminoclonidine, had the characteristics of a partial agonist. The rank order of potency for antagonists to inhibit the activation of GTPase by 1 microM (-)-epinephrine was yohimbine = rauwolscine > idazoxan = oxymetazoline = phentolamine = WB4101 = (+)-mianserin > (-)-mianserin > prazosin > (-)-propranolol. Negative logarithms of the IC50 values of these antagonists corresponded well with the negative logarithmic values of Ki(pKi) for the alpha 2A-adrenergic receptors determined by a receptor-binding technique in human platelets. These results indicate that epinephrine stimulates high-affinity GTPase activity of G proteins (putatively Gi2), which are also coupled with thrombin receptors, in a Mg(2+)-dependent and stereospecific manner, via alpha 2A-adrenergic receptor activation in human platelet membrane preparations.

An outbreak of Salmonella typhimurium infection in bengalees, a variety of Lonchura striata

Bengalees (a variety of Lonchura striata) in an aviary in Nagano Prefecture died of severe diarrhea in 1991. Pathological examination revealed slight enlargement of the liver and spleen. Histopathologically, necrotic granulomatous lesions were seen in the liver. Salmonella Typhimurium was isolated from the main organs and fecal samples. No evidence of Newcastle disease or chlamydiosis was detected. The disease was finally diagnosed as S. Typhimurium infection in bengalees. In spite of some countermeasures, 198 out of 268 birds died within 6 months, a mortality rate of 74%. Epizootiological survey revealed that the infection was transmitted by birds introduced from another prefecture. This is the first report of S. Typhimurium infection in bengalees.

Formation of farnesal and 3-hydroxy-2,3-dihydrofarnesal from farnesol by protoplasts of Botryococcus braunii

Farnesal and 3-hydroxy-2,3-dihydrofarnesal (3-hydroxy-3,7,11-trimethyl-6,10-dodecadiene-1-al) were formed from farnesol when the alcohol was incubated with the protoplast of Botryococcus braunii B race strain. This fact suggests the existence of farnesal hydratase in the alga. Feeding experiments showed that both farnesal and 3-hydroxy-2,3-dihydrofarnesal were efficiently incorporated into botryococcenes, triterpenoid hydrocarbons of the alga.

[Multiple myeloma associated with diffuse parenchymal amyloidosis of the lung]

A 58-year-old woman was hospitalized in March, 1991, with slight breathlessness on exertion. Laboratory investigations revealed M-protein (IgG lambda type, 7,575mg/dl) in serum, and Bence-Jones proteinuria. Osteolytic bone lesions were noted roentgeno-logically. Bone marrow aspiration showed the presence of 19% of atypical plasma cells, and the case was diagnosed as multiple myeloma. The chest X-ray film showed bilateral diffuse micronodules, which were found by a transbronchial lung biopsy to be diffuse parenchymal amyloid deposits. The patient was treated with melphalan, prednisolone and interferon-alpha for 6 courses. Clinical symptoms improved but no decrease of the level of M-protein was observed. The patient is still alive without changes of pulmonary shadows on X-ray films for the past 2 years.

[Clinical characteristics of impacted bile duct stone in the elderly]

Acute cholangitis due to impacted bile duct stone is sometimes fatal and require prompt bile duct decompression. Particularly, AOSC (acute obstructive suppurative cholangitis) is the most serious form of bacterial cholangitis and its prognosis is usually very poor when treated conservatively. We have been treated impacted bile duct stones by decompressing the duct endoscopically. Here, we report the characteristics of our elderly patients with impacted bile duct stones who received urgent decompression treatment mainly by endoscopic techniques. In the endoscopical treatment group, the number of patients with AOSC was 5 out of 46 AC (acute cholangitis) patients (11%) under 69 years old, 14 out of 52 (27%) from 70 to 79 years old, and 12 out of 28 (43%) over 80 years old. Obviously, the severity of acute cholangitis (ratio of AOSC to AC) was higher in the elderly. This tendency was similar to the patients who received urgent transhepatic decompression treatment, although they were small in number. In all the patients treated, 7 were classified into the most serious AOSC category with Reynolds' sign, and notably 6 out of 7 were over 70 years old. More strikingly, 5 of 7 patients were over 80, and their mortality rate was indeed high. Thus, in the elderly, bacterial cholangitis by impacted bile stones was a very serious condition. Especially, the outcome of AOSC over 80 years old with Reynolds' sign was very poor, in spite of emergency endoscopic treatment.

Nafamostat mesilate reduces blood loss during open heart surgery

BACKGROUND

Nafamostat mesilate (FUT-175) is a protease inhibitor inactivating coagulation, fibrinolysis, and platelet aggregation. A prospective, randomized trial was performed to assess the efficacy of FUT-175 in the reduction of postoperative bleeding tendency.

METHODS AND RESULTS

FUT-175 was infused at a rate of 40 mg/h during cardiopulmonary bypass (CPB) along with 300 IU/kg of heparin in 20 patients undergoing aortocoronary bypass surgery (FUT group). This group was compared with another group of 20 patients undergoing aortocoronary bypass surgery, who were given only heparin (control group). Blood concentrations of FUT-175 and activated clotting time increased after cooling, peaking at 2050 +/- 1190 ng/mL and 2136 +/- 983 seconds at the lowest temperature and recovered after rewarming to values of 166 +/- 118 ng/mL and 510 +/- 148 seconds, respectively, at the end of CPB. In the FUT group, platelet counts were significantly higher at the end of CPB than those in the control group (168 +/- 10 versus 136 +/- 9 x 10(3)/mm3, P < .05). In the FUT group, serum concentrations of beta-thromboglobulin (307 +/- 102 versus 537 +/- 391 ng/mL, P < .05), PIC (3.6 +/- 1.7 versus 5.8 +/- 3.8 micrograms/mL, P < .05) and FDP (20.2 +/- 7.0 versus 41.4 +/- 11.9 ng/mL, P < .01) were significantly lower than those in the control group at the end of CPB. However, serum concentrations of TAT, FPA, and FPB beta 15-42 showed no significant differences between groups. FUT-175 significantly reduced heparin dosage and 24-hour postoperative blood loss (19,200 +/- 3200 versus 29,100 +/- 7700 IU, P < .01, and 382 +/- 129 versus 576 +/- 375 mL, P < .05).

CONCLUSIONS

FUT-175 inhibits fibrinolysis and preserves platelet counts and function during CPB and reduces blood loss during open heart surgery.

[Lethal arrhythmias in a patient with coarctation of the aorta and severe heart failure: their control by combination of low dose amiodarone with procainamide for 3 years]

In 1970, a 19 year-old man was diagnosed as having coarctation of the aorta (CoA). But the patient and his family rejected further examination for CoA and high blood pressure was treated after that time. When the patient was 37 years old, he was admitted to our hospital because of congestive heart failure. During the 2nd admission for determining the operability of CoA in December, 1988, non-sustained ventricular tachycardia was detected. Immediately, intravenous administration of lidocaine or/and mexiletine were started. However, cardiac arrest occurred. After his recovery, lethal ventricular arrhythmias were still observed frequently despite administration of class Ia or Ib antiarrhythmic drugs. Oral amiodarone administration (600 mg) with procainamide (1000 mg) was started on 1st of May, 1989. Axillo-femoral bypass graft was performed during the 2nd admission because curable operation was abandoned because of severely impaired cardiac function. Subsequently, the patient was admitted 5 times due to exacerbated congestive heart failure. However, lethal arrhythmias were able to be controlled by the combination of low dose amiodarone (100-200 mg) with procainamide until he died of congestive heart failure on 9th of May, 1992. We reported a rare adult case with CoA and severe heart failure. Lethal arrhythmias in this case were well controlled by the combined administration of low dose amiodarone with procainamide regardless of severely impaired cardiac function.

Crystallization and preliminary X-ray diffraction studies of Bacillus stearothermophilus farnesyl diphosphate synthase expressed in Escherichia coli

Thermostable farnesyl diphosphate synthase (EC 2.5.1.10) from Bacillus stearothermophilus, which was overexpressed in Escherichia coli, has been crystallized by the vapor-diffusion procedure. Tetragonal crystals were obtained using ammonium sulfate as a precipitant. The crystals diffracted X-rays to about 3 A resolution. The diffraction pattern indicated that the space group is I4(1)22 with unit-cell dimensions of a = b = 114 A and c = 247 A. It is thought that the asymmetric unit comprises two or three molecules of farnesyl diphosphate synthase.

[Evaluation of the postoperative regrowth of the acoustic neurinomas]

Although recent advances in microsurgical removal of acoustic neurinomas has made it possible to preserve, morphologically, the cochlear nerve as well as the facial nerve, functional impairment of the facial nerve is often encountered following total removal of the tumor. In order to avoid such functional morbidity, a surgical procedure can be proposed in which the tumoral capsule attached to a functional structure such as the facial nerve is intentionally left. Along with this surgical procedure and postoperative course observation, postoperative regrowth of the tumor should be precisely evaluated. A few recent reports about this problem have been published since CT scan and MRI have become available. The authors reviewed 66 cases in which postoperative evaluation by high resolution CT scan of the acoustic neurinomas has been carried out in their department more than one year after surgery. Multiple factors such as age at onset, sex, preoperative period, tumor size, vascularity, extent of the tumor removal, residual site, and pathological findings on HE stain were studied in relation to the tumor regrowth. Four cases showed regrowth of the tumor, and one of these tumors was reoperated on. The percentage of regrowth was 7.5% among the tumors which were not totally removed. No significant risk factors for tumor regrowth were noticed in these cases, but tumor regrowth tended to be found in younger patients. The residual tumors which showed regrowth were always located in the internal auditory meatus. In this study, it is apparent that, percentagewise, tumor regrowth is not so prevalent.(ABSTRACT TRUNCATED AT 250 WORDS)

Enhancement of cytotoxicity of doxorubicin by verapamil in the hepatic artery infusion for liver tumors in rats

BACKGROUND

The calcium channel blocker has been demonstrated to be effective in the accumulation and retention of chemotherapeutic agents in tumor cells.

METHODS

The effect of verapamil on cytotoxicity of doxorubicin was investigated in a hepatic artery infusion (HAI) for liver tumors of Walker 256 carcinosarcoma in rats. Doxorubicin was infused by way of a hepatic artery by a bolus injection intra-arterially (IA) (1 mg/kg) and a continuous infusion intra-arterially (CIA) (6 mg/kg/day for 6 days).

RESULTS

Doxorubicin increased 90% and 66% in tumor tissue following HAI of verapamil by a bolus and continuous infusion (P < 0.05), respectively. However, no enhancement of the accumulation of doxorubicin in the tumor tissue was found in an intravenous administration of verapamil. The CIA infusion of verapamil with doxorubicin inhibited the tumor growth by 73% in comparison with doxorubicin only (P < 0.05). Verapamil administered intravenously (IV) could not induce this inhibitory effect. The CIA administration of verapamil reduced the serum concentration by 45% (P < 0.001) in comparison with the CIV route. Furthermore, the administration of verapamil did not increase the accumulation of doxorubicin in the normal liver and heart tissues. No enhancement of bone marrow suppression and hepatic biochemical influence by doxorubicin was revealed by the concomitant use of verapamil.

CONCLUSIONS

The continuous HAI of verapamil remarkably enhanced the cytotoxicity of HAI with doxorubicin for the treatment of hepatic tumor without aggravating the side effects induced by doxorubicin.

Subdiaphragmatic vagotomy abolishes increase in ornithine decarboxylase activity of rat duodenal mucosa after ischemia-reperfusion in superior mesenteric artery

In order to evaluate the systemic and neural factors on ornithine decarboxylase (ODC) activity of rat intestinal mucosa, ODC activity in duodenal mucosa, where blood flow did not decrease by superior mesenteric artery (SMA) occlusion, was compared to that of jejunal and ileal mucosa, where blood flow decreased to 90% of the initial value after SMA occlusion. Rats were allowed to recover after SMA occlusion before harvesting intestinal mucosa for measuring ODC activity. ODC activity in the jejunum and the ileum increased markedly 6 h after ischemia-reperfusion (I/R) and more than 72 h were required for ODC activity to return to normal. ODC activity in the duodenum did not change until 24 h after I/R, but the activity increased 48 h after I/R, and this increase continued for 2 days. Subdiaphragmatic vagotomy completely abolished the increase in ODC activity in the duodenum, whereas the same procedure had no influence on ODC activity in the jejunum or the ileum. These results indicate that a neural signal from the central nervous system via the efferent vagal nerve following I/R was an important factor in the increase in ODC activity of duodenal mucosa, where blood flow was not influenced by SMA occlusion.

Enhancement of cytotoxicity of doxorubicin by verapamil in the hepatic artery infusion for liver tumors in rats

BACKGROUND

The calcium channel blocker has been demonstrated to be effective in the accumulation and retention of chemotherapeutic agents in tumor cells.

METHODS

The effect of verapamil on cytotoxicity of doxorubicin was investigated in a hepatic artery infusion (HAI) for liver tumors of Walker 256 carcinosarcoma in rats. Doxorubicin was infused by way of a hepatic artery by a bolus injection intra-arterially (IA) (1 mg/kg) and a continuous infusion intra-arterially (CIA) (6 mg/kg/day for 6 days).

RESULTS

Doxorubicin increased 90% and 66% in tumor tissue following HAI of verapamil by a bolus and continuous infusion (P < 0.05), respectively. However, no enhancement of the accumulation of doxorubicin in the tumor tissue was found in an intravenous administration of verapamil. The CIA infusion of verapamil with doxorubicin inhibited the tumor growth by 73% in comparison with doxorubicin only (P < 0.05). Verapamil administered intravenously (IV) could not induce this inhibitory effect. The CIA administration of verapamil reduced the serum concentration by 45% (P < 0.001) in comparison with the CIV route. Furthermore, the administration of verapamil did not increase the accumulation of doxorubicin in the normal liver and heart tissues. No enhancement of bone marrow suppression and hepatic biochemical influence by doxorubicin was revealed by the concomitant use of verapamil.

CONCLUSIONS

The continuous HAI of verapamil remarkably enhanced the cytotoxicity of HAI with doxorubicin for the treatment of hepatic tumor without aggravating the side effects induced by doxorubicin.

[Spinocerebellar ataxia 1--clinical study of 17 patients in a large pedigree]

We studied a large pedigree with dominant spinocerebellar ataxia, genetically and clinically. At now, 27 members over 5 generations have been affected. Linkage study for the disease locus to D6S89 in a total of 44 individuals showed maximum lod scores of 3.99 at theta = 0.000. This result indicates that the disease locus of this pedigree locates near D6S89 on chromosome 6p (SCA 1). We studied 17 patients clinically. Mean age at onset was 37.7 +/- 8.6, and mean duration after onset was 11.3 +/- 6.8 years. Their clinical features were characterized by progressive ataxia, pyramidal involvement with hyperreflexia or spasticity, and mild posterior column involvement. Mild gaze nystagmus at early stage became unclear with the progress of illness. The frequent signs in the advanced stage were diffuse amyotropy, twitching of face or tongue, bulbar palsy, slow saccade, external ophthalmoparesis, mydriasis, coarse postural tremor, and dementia with emotional disturbance. There are so much clinical similarities between our pedigree and other SCA 1 pedigrees in the literature. Generally, SCA 1 shows hyperreflexia, spasticity, and terminal slow saccade. On the other hand, non-SCA 1 type OPCA is characterized by progressive hyporeflexia, slow eye movement from early stage, and frequent choreoathetosis. Gaze nystagmus, external ophthalmoparesis, amyotrophy, and spasticity are common in both SCA 1 and Machado-Joseph disease (MJD). However, they are more frequent in MJD than SCA 1. Moreover, extrapyramidal signs, such as dystonia, are rare is SCA 1. Based on these difference, SCA 1 could be clinically differentiated from other similar hereditary ataxias.