Decreased expression of c-myc family genes in thymuses from myasthenia gravis patients

The thymus is a critical organ for the elimination of autoreactive T cells by apoptosis. We studied the expression of apoptosis-associated genes, bcl-xL, bad, caspase-3, and c-myc family genes in myasthenia gravis (MG) thymuses. We observed that the mRNA levels of myc family genes, c-myc and max, were markedly reduced in MG thymuses. These results indicate that c-myc-mediated signaling is abnormal in MG thymuses. The levels of molecules whose expressions are associated with myc, such as STAM, prothymosin-alpha, and NFkappaB, were also analyzed.

Elevated serum soluble CD44 level in sarcoidosis

Sarcoidosis is a chronic multi-organ granulomatous disease of unknown etiology. Several studies have suggested an involvement of immunologic background in sarcoidosis. The lymphocyte surface marker CD44 is a multifunctional molecule which mediates the adhesion of lymphocytes to the extracellular matrix. Recently, we developed a system to quantitate soluble CD44 (sCD44) which we employed to determine serum and bronchoalveolar lavage fluid (BALF) levels of sCD44 to obtain further insights into immunologic aspects of sarcoidosis. Serum sCD44 levels were measured in 13 consecutive patients with sarcoidosis and 56 normal healthy controls using enzyme-linked immunoabsorbent assay. BALF sCD44 levels were also measured in 11 patients with sarcoidosis and 10 normal healthy controls. In patients with sarcoidosis, the serum sCD44 level was significantly higher than that of normal controls (348.5+/-164.2 ng/ml vs 145.4+/-22.9 ng/ml; p<0.001). Also BALF sCD44 levels tended to be higher in sarcoidosis than in normal controls (23.7+/-13.4 ng/ml vs 18.1+/-8.4 ng/ml), but no statistically significant difference was recognized. We also found that there was a positive correlation between the serum sCD44 and angiotensin converting enzyme (r=0.78). Our data indicate that sCD44 may be related to immunologic background and may be a useful new marker of sarcoidosis.

Acute fracture of the neck of the femur. An assessment of perfusion of the head by dynamic MRI

We performed dynamic MRI of the femoral head within 48 hours of injury on 22 patients with subcapital fracture of the neck of the femur and on a control group of 20 of whom ten were healthy subjects and ten were patients with an intertrochanteric fracture. Three MRI patterns emerged when the results between the fractured side and the contralateral femoral head were compared. In all of the control group and in those patients who had undisplaced fractures (Garden stages I and II), perfusion of the femoral head was considered to be at the same level as on the unaffected side. In patients with displaced fractures (Garden stages III and IV) almost all the femoral heads on the fractured side were impaired or totally avascular, although some had the same level of perfusion as the unaffected side. We conclude that dynamic MRI, a new non-invasive imaging technique, is useful for evaluating the perfusion of the femoral head.

Acute fracture of the neck of the femur

We performed dynamic MRI of the femoral head within 48 hours of injury on 22 patients with subcapital fracture of the neck of the femur and on a control group of 20 of whom ten were healthy subjects and ten were patients with an intertrochanteric fracture. Three MRI patterns emerged when the results between the fractured side and the contralateral femoral head were compared. In all of the control group and in those patients who had undisplaced fractures (Garden stages I and II), perfusion of the femoral head was considered to be at the same level as on the unaffected side. In patients with displaced fractures (Garden stages III and IV) almost all the femoral heads on the fractured side were impaired or totally avascular, although some had the same level of perfusion as the unaffected side. We conclude that dynamic MRI, a new non-invasive imaging technique, is useful for evaluating the perfusion of the femoral head.

[A case of systemic lupus erythematosus developed with intestinal perforation]

A case of intestinal perforation associated with SLE is presented. A 54-year-old woman was diagnosed as having SLE twenty-five years ago when she had facial erythema, photosensitivity, oral aphtha, polyarthraliga, leukopenia, positive LE cell and positive antinuclear antibody. She had been treated with prednisolone and admitted to Kushiro City General Hospital because of one month history of fever and anorexia in February 1996. Laboratory findings did not reveal activity of SLE, and a diagnosis of urinary tract infection was made based on the findings of urinalysis. After severe diarrhea, disseminated intravascular coagulation (DIC) developed. A rectal perforation was revealed by endoscopic and radiological examination. An emergency laparotomy revealed necrosis of the rectum and sigmoidostomy was performed. The biopsied specimen of the rectum were diagnosed as gangrene of ischemic colitis histologically. Because of a penetration to the urinary bladder, an ureterocutaneostomy was performed. She died of sepsis and DIC on the 127th day of admission. Only 11 cases of intestinal perforation associated with SLE have been reported in Japan, and the association of vasculitis has been considered. In the present case, the prolonged use of prednisolone might cause the necrotizing ischemic colitis.

[An evaluation of a therapy with antibacterial and antifungal agents infections with hematological disorders]

The primary objective of this study is to confirm the efficacy and safety of combination therapy with antibacterial and antifungal drugs for patients with hematological disorders complicated with infections of unknown causative organisms. The subjects consisted of 55 patients with hematological disorders, 28 males and 27 females, ranging from 1 to 78 years of age, with an average age of 34 years. The breakdown of the patients by disease was: 41 leukemias, 10 malignant lymphomas, 3 myelodysplastic syndromes and an aplastic anemia. All patients were treated with sulbactam/cefoperazone (SBT/CPZ) and aminoglycoside (AG) plus fluconazole (FLCZ) as an empiric therapy. Overall efficacy rate was 54.5% for all the patients: 57.7% for patients with suspected sepsis and 0% for those with pneumonia from which unknown organisms were detected. The efficacy rate was 59.4% for patient who had been previously treated with other antibiotics and 47.8% for those who had not previously been treated. The above results suggested that this combination therapy might be effective for severe infections of unknown causative organisms associated with hematological disorders.

Butyrylcholinesterase-rich neurons in rat brain demonstrated by a sensitive histochemical method

Butyrylcholinesterase (BChE) is a highly active enzyme in brain, but little is known about its physiological functions. One obstacle has been the lack of a sensitive and specific method for determining its cellular localization. We report here on a histochemical technique that has permitted BChE to be detected in neuronal, glial, and vascular structures. The method, which utilizes butyrylthiocholine iodide as the substrate, is a modification of our previously described method for acetylcholinesterase (AChE) histochemistry. BChE-rich neuronal somata stained much more intensely than capillaries or glia. Prominent neuronal groups were located in the anterodorsal, laterodorsal, anteroventral, reuniens, centrolateral, paratenial, and periventricular thalamic nuclei, the laterodorsal tegmental nucleus, the pedunculopontine tegmental nucleus, and the dorsal motor nucleus of vagus. Several other areas of the forebrain and brainstem showed modest numbers of positive cells. No positive cells were detected in the striatum, hippocampus, and most parts of the hypothalamus, which are regions containing numerous AChE-rich neurons. Although the distribution pattern of BChE-rich neurons differed from that of AChE-rich neurons, some neuronal groups contained both esterases. The results suggest that BChE may play a unique role in neuronal function, particularly since many BChE-rich neurons have not been identified as to neurotransmitter type.

[Adult T-cell leukemia/lymphoma, histologically presenting Ki-1 positive anaplastic large cell lymphoma]

A 48-year-old woman was admitted with neck tumors and cutaneous nodules. On the histological basis of the skin nodule biopsy, a metastatic anaplastic carcinoma was suspected. Immunohistochemical studies showed the presence of Ki-1 antigen, IL-2 receptor antigen, leukocyte common antigen (LCA), CD3 and CD4 on the tumor cells compatible with Ki-1 positive anaplastic large-cell lymphoma. This case was, however, finally diagnosed as adult T cell lymphoma (ATL) of a helper/inducer phenotype. She was born in Kagoshima. The serum anti-ATL associated antigen (ATLA) was positive. Southern blot analysis on the DNA extracted from the skin tumor cells showed a monoclonal integration of HTLV-1 proviral DNA. The results suggested that Ki-1 positive lymphomas may include a subset of ATL with a large-cell histology.

Serial changes of SPECT in periodic synchronous discharges in a case with Creutzfeldt-Jakob disease

We conducted serial EEG and SPECT studies on one female with Creutzfeldt-Jakob disease (CJD). In an analysis of EEG, a periodic synchronous discharge (PSD) was observed in the middle of the third stage (terminal stage) of Bernoulli's classification. The frequency of PSD was the highest at the beginning of the third stage, followed by a gradual decrease and disappeared at the end of the third stage. In the middle of the third stage, SPECT disclosed blood flow differences between the cerebrum and other regions (the cerebellum and the brainstem), while no such difference was observed by SPECT at the end of the third stage. It was suggested that the appearance of PSD requires the presence of a pathological change in the cerebrum precedent to other regions.

[Study of IgE.IgG4 antibodies on eczema in infants. II. Clinical characteristics of infants with egg white.RAST 4+]

The author made an assessment in his first report, regarding relationship to the degree of skin involvement. As a result, it was suggested that the extent of eczema is a good index for determining the severity of the allergy and also that the severity of the allergy early in the infancy has a good correlation with egg white.specific IgE antibody. Therefore, an assessment had been made this time regarding the clinical characteristics of 32 infants who have strong reactions (egg white.RAST 4+) to egg white. The results were as follows; 1. All the infants with egg white.RAST 4+ had a systemic eczema, and their IgE antibodies showed high values of 445.6 +/- 626.9 IU/ml. 2. There were many cases with positive multiple allergens. Particularly, all the infants with egg white.RAST 1+ - 2+ were negative to rice and wheat, while 7 cases positive RAST score to rice and 9 cases to wheat were seen out of the 32 who showed the RAST 4+ to egg.white early in the infancy (rice; p less than 0.02 and wheat; p less than 0.01). 3. If the growth curves of the group from which egg and milk were completely eliminated are compared with the curves of the healthy infants, the height and head circumference were entirely in the normal range while the weight and Kaup index had a trend of being a little low, though they were within the normal range. 4. Regarding family history of allergies, past histories of atopic dermatitis on the mother's side were observed at a high rate.

[IgE.IgG4 antibody in eczema in infants between 5-7 months of age. I. Relationship to the degree of eczema involvement]

Assessments have been made of serum IgE and IgA value, specific IgE and IgG4 antibody titers to foods, house dust, mite and percent peripheral++ eosinophil count in 191 infants with and without eczema between 5-7 months of age. Eczema patients were divided into 4 groups according to the degree of eczema involvement and laboratory data were compared between these and not eczematous group. The results were as follows; 1) IgE antibody titers were higher as the degree of eczema involvement increased. 2) RAST positive rates to foods increased with the degree of eczema involvement. Positive rate was highest to egg white followed by milk, soybean, wheat and rice. 3) Only 9 cases were RAST-positive to rice or wheat and all of them had IgE antibodies to other allergens tested. 4) A value of 10 IU/ml, which is the lowest measurable value of IgE in infants was considered to be a little too high to speculate allergy to some foods. 5) Specific IgG4 antibodies were positive only to milk. 6) All the 18 cases with positive milk-specific IgG4 antibody were all negative in milk-specific IgE antibody, and conversely all the 14 cases with positive milk-specific IgE antibody were negative in milk-specific IgG4 antibody. From these results, it was concluded that food allergy is related to the degree of eczema involvement in infants between 5-7 months of age.

[Adult T cell leukemia/lymphoma with hyperprolactinemia: successful treatment by OK432 and PSK]

A 48-year-old woman was admitted in September 1987, because of lumbago and galactorrhea. Peripheral blood analysis showed neutrophilia and eosinophilia without abnormal lymphocytes. The antibody to adult T-cell leukemia (ATL) virus-associated antigen was detected and a hyperprolactinemia was observed. The blastogenic responses to PHA, ConA and PWM were lowered. Brain CT and MRI scannings showed no abnormalities in the hypophysis and hypothalamus, but abdomen CT revealed markedly enlarged abdominal lymph nodes. Two months after the administration of OK432 and PSK, the lymph node swellings disappeared and the responses to PHA, ConA and PWM were normalized, but hyperprolactinemia and galactorrhea persisted. After four months of the remission period, the patient developed lymph node swellings again, and was diagnosed from the biopsy specimen of the retroperitoneal lymph node as having malignant lymphoma of diffuse mixed cell type. Southern blot analysis showed a monoclonal integration of HTLV-I proviral DNA. Despite repeated combination chemotherapies, she died of pneumonia in February 1989. Autopsy revealed marked infiltrations of lymphoma cells in the liver, spleen and lungs, but no abnormality accounting for hyperprolactinemia was detected in the suprasellar regions. This case was of interest in that immunotherapy was effective in achieving a remission and in normalizing immuno-parameters in ATLL.

[An evaluation of combination antibiotic therapy in infections with hematological disorders. Hyogo Cooperative Study Group of Infectious Diseases Complicating Hematological Disorders]

A clinical study was undertaken to determine the effects of combination antibiotic therapy in 104 patients with infections associated with hematological disorders. All patients were treated with sulbactam/cefoperazone (SBT/CPZ) plus an aminoglycoside as an empiric therapy for fever. The overall efficacy rate of the therapy was 63.5%. Efficacy rates were 61.2% and 71.9% when initial neutrophil counts were less than 500/mm3 and over 500/mm3, respectively. No significant difference was found between the cases in which initially used antibiotics were continued (efficacy rate 62.5%) and those in which antibiotics were switched during the course of therapy (65.6%). Antibiotic therapy with SBT/CPZ plus an aminoglycoside provides adequate antibiotic coverage against infections associated with hematological disorders. This combination was highly effective even in the neutropenic periods of febrile patients.

Choline acetyltransferase immunopositive neurons in the lateral septum

A small cluster of choline acetyltransferase (ChAT)-positive neurons was identified immunohistochemically in rat and monkey brain in the ventral portion of the lateral septal nucleus. These multipolar neurons were smaller and much less intensely staining than the medial septal nucleus ChAT-immunopositive group.

Occurrence of diffuse amyloid deposits in the presubicular parvopyramidal layer in Alzheimer's disease

Silver staining by a modified Bielschowsky's technique and immunostaining for beta-amyloid protein BAP have revealed the occurrence of diffuse amyloid deposits bilaterally in the presubiculum in each of fourteen Alzheimer's disease cases examined. Observations on serial blocks show these deposits to be localized in the parvopyramidal layer of the presubiculum proper and the transsubiculum. They are also observed in the cellular islands within the molecular layer of the subiculum but not in the parasubiculum. These amyloid deposits are not accompanied by neurofibrillary tangles, neuropil threads, or the aggregated microglial reaction which is characteristically associated with classic senile plaques. Convergence of input from limbic and cortical areas might play a significant role in the formation of these diffuse amyloid deposits.

Distribution of choline acetyltransferase immunopositive structures in the rat brainstem

The distribution of neurons, fibers and terminal fields in rat brainstem displaying positive immunoreactivity to a polyclonal antiserum to human placental choline acetyltransferase (ChAT) is described. The antiserum was used at the high dilution of 1:10,000 and was coupled with a sensitive detection system using the nickel ammonium sulfate intensification method. In addition to previously described ChAT immunopositive groups of large cells in the cranial motor nuclei, and the parabrachial and reticular complexes, many small or medium size, weakly immunopositive neurons were identified. Some of these appeared in structures in the region of the fourth ventricle, including the area postrema. Others were in structures associated with the superior olivary complex, including the lateral superior olive, and the medioventral, lateroventral and superior periolivary nuclei. Scattered, weakly positive cells were seen in numerous other structures, including the ventral tegmental area of Tsai, central gray, superior colliculus, spinal nucleus of nerve 5, dorsal cochlear nucleus and non-motor regions of the spinal cord. The prominent ascending fiber tract of the laterodorsal tegmental pathway was traceable from the parabrachial area to the subgeniculate region of the thalamus. Prominent terminal fields were seen in a number of brainstem structures, including the superior colliculus, pontine nuclei, anterior pretectal nucleus, interpeduncular nucleus and spinal nucleus of nerve 5. The association of small ChAT positive cells and terminal fields with many sensory structures suggests a significant cholinergic participation in the physiology of sensory function.

[CALLA-positive leukemic multiple myeloma of IgA-kappa type]

A 73-year-old man was admitted into the hospital because of lumbago in October, 1986. Laboratory examination on admission showed anemia, an IgA-kappa Bence Jones proteinemia. The bone marrow picture disclosed a marked involvement by the neoplastic cells, followed by leukemic conversion 2 weeks later. The leukemic cells displayed a lymphoblastoid appearance on light microscopy, but rather compatible with plasma cells on electron microscopy, showing some strands of rough endoplasmic reticulum and a prominent Golgi apparatus in the cytoplasm. The cells expressed a wide spectrum of surface markers, including those of plasma cell (PCA-1, OKT10), B cell (B1, sIg) and CALLA. Reverse hemolytic plaque assay disclosed the immunoglobulin production of monoclonal kappa chain, but a heavy chain production was recognized only in a small proportion of the cells. Under the diagnosis of multiple myeloma, he was treated with vincristine, cyclophosphamide, and prednisolone. But he died of renal failure complicating hypercalcemia after only three months of the admission in accordance with previous reports that CALLA-positive myeloma was associated with poor prognosis. This case may also represent the clinical, morphological and phenotypic diversity in multiple myeloma.

Cholinergic divergent projections from rat basal forebrain to the hippocampus and olfactory bulb

Cholinergic neurons in the basal forebrain which project to both the hippocampus and olfactory bulb were identified in the rat by using twin fluorescent retrograde tracers combined with fluorescence immunohistochemistry for choline acetyltransferase (ChAT). The majority of neurons simultaneously labeled with the two tracers were also identified as being ChAT-positive. They were located at the border between the horizontal and vertical limbs of the diagonal band of Broca. Their numbers were very small compared with neurons singly labeled from each of the projection areas.

Reactive microglia in patients with senile dementia of the Alzheimer type are positive for the histocompatibility glycoprotein HLA-DR

HLA-DR is a class II cell surface glycoprotein of the human histocompatibility complex usually expressed on the surface of cells that are simultaneously presenting foreign antigen to T-lymphocytes. Using immunohistochemical procedures with two specific monoclonal antibodies to HLA-DR, HLA-DR-positive reactive microglia were found in gray matter throughout the cortex of postmortem brains of patients with senile dementia of the Alzheimer type (SDAT) and were particularly concentrated in the areas of senile plaque formation. Double immunostaining with antibodies to glial fibrillary acidic protein (GFAP) showed that the HLA-DR-positive cells were different from the reactive astrocytes although the occasional positively staining giant astrocyte was also seen. Small numbers of resting microglia were HLA-DR-positive in white matter of both normal and SDAT brains. The SDAT cases also had reduced cortical choline acetyltransferase (ChAT) levels. In the 11 brains studied, the number of hippocampal HLA-DR-positive cells was positively correlated with the numbers of plaques and negatively correlated with average cortical ChAT.

Coupled intracellular horseradish peroxidase-monoamine oxidase histochemistry: description of the technique and its application to the study of physiologically identified tuberomammillary neurons

A technique is described which couples visualization of intracellular horseradish peroxidase (HRP) with histochemical localization of monoamine oxidase (MAO), permitting simultaneous study of histochemistry, morphology and physiology in a single neuron. Using this technique, individual neurons int he tuberomammillary nucleus of the hypothalamus were stained in a Golgi-like fashion, revealing their somatodendritic morphology in detail. The technique has general applications as a method for conferring cytochemical specificity to intracellular staining of other MAO positive neurons, to retrograde transport of HRP by MAO positive neurons, as well as for ultrastructural studies of positively stained neuronal elements.

Distribution of choline acetyltransferase-containing neurons of the hypothalamus

A system of small to medium size choline acetyltransferase (ChAT)-containing neurons has been identified in rat, monkey and human hypothalamus. A highly sensitive polyclonal anti-human placental ChAT rabbit serum, combined with a nickel ammonium sulfate second antibody intensification method, was used to identify these relatively weakly staining ChAT-positive neurons. The most prominent hypothalamic group consisted of small neurons in the infundibular (arcuate) nucleus. Fibers extended towards the infundibulum. Other ChAT-positive cells were not identified with specific hypothalamic nuclei but were scattered loosely in the surrounding matrix. They fell into two broad complexes: a medially distributed one close to the third ventricle and running rostrocaudal to caudoventral; and a lateral one distributed principally in the region of the medial forebrain bundle. The most laterally placed hypothalamic ChAT-positive neurons slightly overlapped with the large, intensely staining cells of the medial basal forebrain cholinergic complex. The identification of these cells helps to account for previous biochemical and pharmacological studies which have strongly indicated the presence of intrinsic cholinergic neurons in the hypothalamus.

Light microscopic evidence for a substance P-containing innervation of the human nucleus basalis of Meynert

A two color histochemical/immunohistochemical method was used to demonstrate substance P and acetylcholinesterase in sections of the human nucleus basalis of Meynert (nbM). Substance P-immunoreactive terminal-like structures were found to make contact with magnocellular, acetylcholinesterase-positive perikarya and primary dendrites throughout all subdivisions of the nbM. This apparent innervation of nbM neurons was in most cases a relatively sparse one, but a small percentage of these neurons appeared to be recipients of a very heavy innervation which covered their perikarya and primary dendrites.

Acetylcholinesterase fibers and the development of senile plaques

A new, highly sensitive histochemical technique for actylcholinesterase (AChE) was applied to a study of Alzheimer's disease brain tissue. Many immature senile plaques were seen to be developing along AChE-positive axons in the hippocampus and neocortex. Single fibers often displayed multiple lesions, showing stages of initial swelling, ballooning with the appearance of AChE in the surrounding extra-axonal space, and development of an AChE-amyloid intense core accompanied by a weakly staining AChE-positive halo. Except for the core and halo, AChE-positive material was seldom detected in so-called mature plaques which are large and incorporate many degenerating neuritic elements surrounding an amyloid core. Lesion data in rats established the relationship between AChE-positive neocortical axons and medial basal forebrain cholinergic cells. In Alzheimer's disease tissue, many degenerating neurons in the basal forebrain were detected by the AChE histochemical stain, along with pathological alterations in the proximal axons en route to their cortical terminal fields. These data provide direct evidence of an association between the cholinergic system of the basal forebrain and the early formation of senile plaques in the cortex in Alzheimer's disease.

Perfusion-fixation of the human brain for immunohistochemistry: comparison with immersion-fixation

A method of perfusion-fixation of the human brain is described and compared with immersion-fixation by immunoperoxidase staining for several substances (tyrosine hydroxylase, substance P, choline acetyltransferase, glutamate decarboxylase, Met-enkephalin, and neuron-specific enolase) in human striatum. Results from 1-cm slices fixed by immersion for 1, 2, 4 and 8 days were compared with results from slices of perfused brain postfixed for the same time periods. The fixative used in all steps was 4% paraformaldehyde at 4 degrees C. In the immersion-fixed brains, optimal immunoreaction for tyrosine hydroxylase and glutamate decarboxylase was limited to a depth of 1-2 mm from the surface of the brain slice. In contrast, staining density in perfusion-fixed brains was relatively homogeneous and of high quality. The other antigens studied displayed more uniform staining throughout the section with both perfused and immersed brains. Investigators intending to study human brain immunohistochemistry using immersion-fixation should be aware of the possibility of depth-related variations in staining intensity and would be wise to determine whether this effect is significant for the antigens they choose to study.

Transplantation of cultured human adrenal chromaffin cells into 6-hydroxydopamine-lesioned rat brain

Adult young rats were subjected to a unilateral 6-hydroxydopamine lesion of the nigrostriatal dopamine pathway and then given intrastriatal grafts of human fetal adrenal chromaffin cell cultures. Amphetamine-induced ipsiversive turning behavior in the lesioned rats was largely reversed in four of eight rats given such transplants when tested at 1.5 and 4.5 months post-transplantation. Two rats showed a transient recovery at 1.5 months followed by deterioration at 4.5 months, while two other rats showed continuous deterioration. Six rats given sciatic nerve grafts as controls all showed deterioration from the pretransplantation levels. Catecholamine fluorescent and immunohistochemical examination of chromaffin-cell-transplanted brains demonstrated neurons and neuronal processes positive for catecholamines or tyrosine hydroxylase in the transplanted area. This transplantation of cultured human fetal cells to an animal model may provide the necessary basic experimental system for assessing the possible utility of human neuronal transplants.

Visualization of detailed acetylcholinesterase fiber and neuron staining in rat brain by a sensitive histochemical procedure

A sensitive method for acetylcholinesterase (AChE) histochemistry has been developed which permits simultaneous observation of fine fiber processes and neuron cell bodies. In rat brain, distinctive configurations can be observed which have been difficult to see by other techniques. The staining procedure involves two steps. Tissue sections are incubated first in Karnovsky and Roots medium diluted one-hundredfold; and then with a mixture containing diaminobenzidine (DAB) and H2O2. The reaction product of the first step induces cleavage of hydrogen peroxide in the second step, with a resulting oxidation of DAB to yield a fine precipitate. Addition of metal ions, such as nickel, to the DAB-H2O2 mixture produces high-contrast, Golgi-like images of neuron structures. The technique is much more sensitive than previous methods and greatly reduces background staining caused by crystallization of reaction products. Many potential applications exist for this new technique, in addition to the initial results described here.

Cortical metabolism, acetylcholinesterase staining and pathological changes in Alzheimer's disease

The local cerebral metabolic rate for glucose (LCMRgl) was determined by positron emission tomography (PET) using the 18F-fluorodeoxyglucose method in a series of Alzheimer patients and normal controls. The LCMRgl declined in the cerebral cortex with age, but the decrement was significantly greater in the clinically diagnosed Alzheimer's cases. Comparison of PET and psychological data indicated that, as the disease progressed clinically, the reduction in cortical LCMRgl and the number of cortical regions involved also increased. Variable regions of cortex were involved in the early stages but the temporal, parietal and frontal regions were most typically affected. One case coming to autopsy showed that the severity of the LCMRgl decline paralleled loss of neurons in the cortex and their replacement with astroglia. A case of Pick's disease coming to autopsy had shown a different and highly characteristic pattern of cortical metabolic defect. In this case also a poor metabolic rate was associated with extensive gliosis. Acetylcholinesterase (AChE) staining of the cerebral cortex in elderly normals and Alzheimer's disease cases with a new, highly sensitive method showed that in Alzheimer's disease there was an extensive loss of AChE-positive fibers with senile plaques frequently incorporating AChE-positive fiber debris. AChE staining of the substantia innominata area, where the cells giving rise to these neocortical fibers are presumably located, also showed evidence of degenerating cells and fibers.

The cholinergic system of the human hindbrain studied by choline acetyltransferase immunohistochemistry and acetylcholinesterase histochemistry

A map of cholinergic cells of the human brainstem identified by immunohistochemistry of choline acetyltransferase (ChAT) is presented, along with a map of acetylcholinesterase (AChE)-containing cells and fibers. ChAT-positive structures belong to 4 brainstem systems: the cranial motor nuclei; the parabrachial complex; the reticular system; and the vestibular system. All motor nuclei of the cranial nerves, as well as the nucleus supraspinalis, are ChAT-positive. The positively staining structures of the parabrachial system include the nucleus tegmentali pedunculopontinus, and the nuclei parabrachialis medialis and lateralis. Nuclei of the reticular system containing some ChAT-positive cells include the nucleus reticularis pontis oralis and caudalis, the nucleus reticularis tegmenti pontis, the nucleus reticularis gigantocellularis, the nucleus reticularis lateralis and the formatio reticularis centralis (medulla). Structures of the vestibular and auditory systems which contain some ChAT-positive cells include the nucleus vestibularis lateralis, and the nuclei olivaris superioris medialis and lateralis. All ChAT-positive structures stain strongly for AChE. AChE-positive, ChAT-negative structures were noted in several sensory systems. The substantia nigra, locus coeruleus and raphe nuclei, known to contain non-cholinergic cells, also stain positively. The significance of the AChE-positive, ChAT-negative staining in most structures remains to be determined. A knowledge of the cholinergic systems of human brain may be important to an understanding of the pathology of a number of diseases.

Distribution of gamma-aminobutyric acid-immunoreactive neurons in the septal region of the rat brain

The distribution of gamma-aminobutyric acid-immunoreactive (GABA-I) elements was examined in the septal region of the rat brain. The indirect peroxidase-antiperoxidase technique was used with anti-GABA antibodies in normal and colchicine-pretreated rats, with or without use of detergent in the incubation medium. Intraventricular injection of colchicine did not result in any change in the staining of neuronal perikarya. Intraseptal injections increased the intensity of labelling of GABA-I cell bodies in the lateral septal nucleus and increased the number of labelled cells in the medial septal nucleus and diagonal band of Broca (dbB). Triton X-100 added to the incubation media decreased the intensity of staining and number of GABA-I somata in all septal nuclei with a concentration-dependent effect. No change was observed concerning GABA-I varicosities. The septal area, including the lateral, medial, and triangular septal nuclei; the anterior rudiment of the hippocampus; the island of Calleja magna; the septofimbrial nucleus; the bed nucleus of the stria terminalis; and the dbB showed a strong reaction to anti-GABA antibodies with regard to GABA-containing surrounding structures. GABA-I axonal varicosities were observed in all the regions with an uneven distribution. The highest density was found in the dorsal and ventral parts of the lateral septal nucleus and in a band situated between the dbB and the nucleus accumbens. Labelled varicosities were frequently observed surrounding GABA-I and nonimmunoreactive cell bodies. GABA-I somata ranged from 10 to 30 micron in diameter. Small neurons were present in great number at the ventricular border and in the zona limitans. Medium-size and large neurons were mostly observed in the medial part of the dorsal lateral nucleus and in the intermediate lateral nucleus.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical studies of adoptive immunotherapy of human disseminated brain tumors with LAK cells and recombinant interleukin-2]

In previous in vitro studies, the authors showed that recombinant interleukin-2 (rIL-2) stimulated peripheral blood lymphocytes (PBL) from patients with malignant brain tumors to generate cells that were lytic for fresh autologous tumor but not for lymphocytes or lymphoblasts. We then tried the adoptive transfer of such lymphokine-activated killer-(LAK) cells induced from patients with meningeal gliomatosis (MG) and meningeal carcinomatosis (MC). PBL fractions were separated into a plastic bag by leukophoreses using HEMONETICS V 50. PBL were then harvested by LSM (Litton Bionetics, Kensington, Md.) gradient centrifugation according to the standard method. Human LAK cells were generated by placing 5 X 10(7) PBL in 10-cm diameter plastic dishes (Falcon) holding 20 ml of complete medium (CM) containing 100 units of rIL-2 (TGP-3, provided by TAKEDA Chemical Industries, Ltd.). The CM consisted of RPMI P640 with 0.1 mM nonessential amino acids, 1 microM sodium pyruvate, 5 X 10(-5) M 2-mercaptoethanol, 50 micrograms/ml of gentamicin sulfate, 0.03% glutamine and 2% heat-inactivated human AB serum. The dishes were incubated horizontally at 37 degrees C in a 5% CO2 atmosphere for 72-96 hours. The LAK cells were then harvested, washed three times with Hanks' balanced salt solution (HBSS) and resuspended in HBSS for transfer to patients. 1-2 X 10(8) LAK cells were injected intrathecally through Ommaya's reservoir or a V-P shunt reservoir twice a week. Portions of LAK cells were tested for cytotoxicity in vitro. During the adoptive transfer of LAK cells, patients were given intravenous injections of 500 units of rIL-2 every day. Case 1: A 29-year-old man with meningeal gliomatosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Cortical projections of monoamine oxidase-containing neurons from the posterior hypothalamus in the rat

Monoamine oxidase (MAO) histochemistry combined with retrograde horseradish peroxidase tracing of neurons demonstrated that MAO-containing neurons in the tuberal, caudal and postmamillary caudal magnocellular nuclei of the hypothalamus project to various cerebral cortices.

Monoamine oxidase-containing neurons in the cat hypothalamus: distribution and ascending projection to the cerebral cortex

Using a recently developed monoamine oxidase (MAO) histochemical technique, we show the existence of MAO-containing neurons in the cat hypothalamus. In conjunction with retrograde tracer technique with horseradish peroxidase, we further demonstrate that virtually all posterior hypothalamic neurons projecting directly to the occipital cortex contain MAO, an amine catabolizing enzyme.