[A case of post-traumatic autobiographic amnesia].

A 23-year-old woman who was in the ninth month of pregnancy suffered a head injury by falling from the stairs. She regained consciousness in the ambulance car, however, could not recall anything about herself. The morning after, her neurological examination disclosed no abnormal findings. She was alert, spatially oriented, but unable to recall any personal information about herself, her work and family contexts. The results of WAIS-R and WMS were within normal range, and she showed a dissociation between a detailed knowledge of public events and famous people and a complete loss of autobiographic information. EEG and brain MRI were normal. Memory loss spontaneously recovered following several months, and 8 month later, the retrograde amnesia had almost resolved. Although it is well-known that autobiographic amnesia usually attributed to psychogenic etiology, the differential diagnosis of the similar selective retrograde amnesia by organic etiology is important.

[The effects of prostaglandin E1 infusion during cardiopulmonary bypass on cardiac and renal function in the early postoperative period].

Postoperative complications after cardiac surgery are mainly caused by the detrimental effects of cardiopulmonary bypass (CPB) on hemodynamics and humoral factors. We studied the effects of prostaglandin E1 (PGE1) infusion on CPB induced organ failure. Twenty-four patients who underwent coronary bypass surgery with normal preoperative cardiac and renal function were divided into two groups. PG group (n = 11) was given PGE1 (0.03-0.05 microgram/kg/min) during CPB while the control group (n = 13) was not. Hemodynamic studies with the Swan-Ganz catheter and renal function tests including serum creatinine (Cr), serum beta 2-microglobulin (s-BMG) and urine beta 2-microglobulin (u-BMG) measurements were performed 24 hours after surgery. After CPB, alpha-adrenergic agent requirement was higher in the PG group than in the control group. In the PG group, the mean cardiac index was slightly higher and the mean left ventricular stroke work index was lower than in the control group. Although the mean systemic vascular resistance index was lower in the PG group, the mean pulmonary vascular resistance index was higher because of the vasoconstrictive action of alpha-adrenergic agents. These differences were seen only immediately after surgery; hemodynamic parameters in both groups were at the same level 3 hour postoperatively. Immediately after surgery, creatinine in the PG group was significantly lower than in the control group. While there was no significant differences in s-BMG between the two groups, u-BMG at 6 and 12 hours postoperatively in the PG group were significantly lower than in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

[Relations between neuropsychological findings and lateral asymmetries of cerebral blood flow measured by SPECT in dementia of Alzheimer type].

We studied 16 right-handed patients clinically diagnosed as dementia of Alzheimer type (6 men, 10 women; aged 63-85, mean 72.8 years). The average duration of symptoms was 2.7 years. Dementia ranged from mild to moderately severe. None had clinical or laboratory evidence of cerebrovascular disease (Hachinski ischemic scores for all patients were 4 or below 4). All received the Wechsler Adult Intelligence Scale (WAIS), Mini-mental State Test (MMS) and Western Aphasia Battery (WAB, First Japanese edition, 1986). Regional cerebral blood flow (rCBF) was evaluated by single photon emission CT (SPECT) with 123I-N-isopropyl-p-iodoamphetamine (123I-IMP), using the Matsuda's quantitative method (Am J Physiol Imag 1: 186, 1986). Regional tracer uptake was measured in regions of interests (ROIs) over right and left frontal, temporal, parietal and occipital cortical regions; basal ganglia; and cerebellar hemispheres. The subjects were divided into three groups on the basis of lateral asymmetries in the temporal and parietal cortexes of rCBF (left < right, n = 5; right < left, n = 3; left = right, n = 8). We decided that lateral asymmetry was present when rCBF for each ROI between left and right sides differs by more than 10%. General score (MMS, T-IQ) was not correlated with asymmetry of cerebral blood flow. Verbal IQ in patients with predominant hypoperfusion of left temporal and parietal lobe was significantly lower than other group, while performance IQ and WAB constructive scores were lower in those with right hemispheric hypoperfusion (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Hyperresponsibility to exogeneous interleukin 4 in atopic dermatitis.

Many humoral and cellular immunological abnormalities have been reported in atopic dermatitis (AD). Since interleukin 4 (IL-4) enhances IgE production and IgE-Fc receptor expression by B cells as well as [3H]-TdR incorporation by T cells, we hypothesized that IL-4 may play an important role in the regulation of the immune response in AD. We examined [3H]-TdR incorporation by peripheral blood lymphocytes from AD patients or from non-AD controls in the presence or absence of IL-4 or interleukin 2 (IL-2). We found that IL-4/IL-2 responsiveness was significantly higher in AD than controls, although the IgE levels did not seem to be correlated with IL-4/IL-2 responsiveness. It is possible that most humoral and cellular immunological abnormalities of AD may be due to this hyperresponsibility to IL-4.

A enzymatic and fluorimetric determination of total bile acid sulfates in human urine.

A simple, precise and sensitive method for separation and determination of total bile acid sulfates in human urine is described. The sulfate fraction of urinary bile acids was separated with lipophilic anion exchange gel, piperidinohydroxypropyl Sephadex LH-20 after sample clean-up with Sep-Pak C18 cartridge. The obtained sulfate fraction was submitted to solvolysis with a small volume of dimethoxypropane-HCl solution and subjected to enzymatic-fluorimetrical assay using 3 alpha-hydroxysteroid dehydrogenase and resazurin. In this method, no influence of existing salts in the reaction mixture on fluorescence intensity was observed and solvolysis reaction was almost complete. Overall recoveries of glycine- and taurine-conjugated bile acid 3-sulfates from normal urine ranged from 90.5 to 93.7% and those of unconjugates from 48.7 to 78.0%. The sensitivity of the described method enabled to estimate total bile acid sulfates with 0.5 ml of normal urine and precision tests showed the satisfactory accuracy. The level of total urinary bile acid sulfates was estimated on some patients with hepatobiliary diseases and healthy subjects.