Tsuneyuki Takeoka

Chemical control of cerebral circulation

This study was undertaken to investigate influences of a new vasodilator, YC-93, a derivative of 1,4-dihydropyridine, on cerebral circulation and cerebrovascular CO2 reactivity. Cerebrocortical PO2, cerebrocortical PCO2, cerebrocortical blood flow and arterial blood pressure were continuously recorded by means of a PO2 electrode, a PCO2 electrode and a plate-type crossed thermocouple flowmeter placed on an exposed pial surface of the cat brain. The changes in each parameter induced by YC-93 were compared with those induced by papaverine hydrochloride. The effects of 5% CO2 inhalation were compared before and after the intravenous injection of YC-93. YC-93 (0.01 mg/kg) showed a more marked and longer-lasting hypotensive effect that papaverine (1 mg/kg) and yet produced a significant increase in cerebrocortical PO2. After the administration of YC-93, the degree of the increase in cerebrocortical PO2 during 5% CO2 inhalation was reduced significantly in comparison with that before the administration. The above data indicates that YC-93 has a vasodilating effect on cerebral blood vessels and that the drug causes a decrease in cerebrovascular CO2 reactivity.

Effect of a new vasodilator (flunarizine) on the cerebral circulation

In order to clarify the effects of flunarizine, a newly-synthesized derivative of piperazine on cerebral circulation and metabolism, cerebrocortical oxygen tension, carbon dioxide tension and cerebrocortical blood flow were continuously recorded, along with a simultaneous monitoring of arterial blood pressure in 11 cats. Maximal changes in cerebrocortical oxygen tension induced by intravenous administration of flunarizine (0.6-1.0 mg/kg) were compared with those of papaverine hydrochloride (1 mg/kg). Flunarizine caused increases in cerebrocortical oxygen tension as well as cerebrocortical blood flow and a decrease in cerebrocortical carbon dioxide tension despite a fall in blood pressure, indicating an increase of cerebral blood flow presumably due to cerebral vasodilatation. Since the increase of cerebrocortical oxygen tension induced by flunarizine was comparable to that induced by papaverine, it was concluded that flunarizine appears to be a potent vasodilator of cerebral vessels.

Myotonic dystrophy and hyperthyroidism

The association of myotonic dystrophy and hyperthyroidism is rare. In the first such case in Japan, hyperthyroidism induced severe exacerbation of muscle weakness, which improved when the thyroid disorder was treated.

Polyacrylamide-gel disc electrophoresis of native cerebrospinal fluid proteins with special reference to immunoglobulins and some clinical applications

Polyacrylamide-gel disc electrophoresis has been applied to the fractionation of CSF samples obtained from 2m control subjects (range of age 16 to 77 yr, mean 41.0 yr) and from 157 patients with various neurological diseases, with the purpose of evaluating the diagnostic significance of separated protein bands. It was found that the immunoglobulins, with some exceptions, were fractionated in the G-zone which was defined as an area between the origin and 0.57 in terms of relative migration based on transferrin (RT). Fourty-four percent of the whole Bence Jones protein bands which were examined were detected in the area of RT 0.70-0.90. The normal values of CSF protein fractions were (means+/-SD):Pre-alb-zone, 10.97+/-2.31%; Alb-zone, 40.74+/-5.72%; A1-zone, 5.25+/-0.72%; A2-zone, 8.23+/-1.24%; B1-zone, 10.82+/-2.18%. B2-zone, 7.94+/-1.93%; G-zone, 16.05+/-2.49%. The following significant results were obtained: (1) When the total protein concentration (TP) of CSF is increased: the percentage of the Pre-alb-zone is lowered and that of the A1- and G-zones is increased in diseases such as neurosyphilis, infectious meningitis, brain tumour, multiple sclerosis, intervertebral disc protrusion and cerebral infarction. The A2-zone was diminished in cerebral infarction, and a similar change was seen in brain tumour with in addition a decrease of the B2-zone; (2) When the TP was normal: the percentage of the G-zone was increased in multiple sclerosis, brain tumour and intervertebral disc protrusion. In the latter 2 disorders the A1-zone also increased. This fraction also increased in the cases of cerebral infarction, whose mean age was, however, much higher than that of the control subjects.

A CASE OF MYOTONIC DYSTROPHY ASSOCIATED WITH HYPERTHYROIDISM

甲状腺機能亢進症とmyotonic dystrophyの合併は極めて希である,最近我々はその1例を経験し,甲状腺機能亢進症と神経・筋疾患との関係を考察する上で,興味ある症例と考え,報告する.症例は53才,女で,昭和50年12月頃初めて立ち上がり困難に気づいたが放置.昭和51年3月頃やせ,発汗,動悸と共に筋力低下は悪化し,立ち上がり不能となり歩行障害や嚥下障害も認めたため,同年7月入院した.入院時び漫性甲状腺腫を触知し,胸鎖乳突筋,僧帽筋をはじめ,下肢では中殿筋や大腿四頭筋にも著明な筋萎縮,筋力低下を認めた.また白内障とmyotonia現象を認め,筋電図でも典型的なmyotonic dischargeを認めた.甲状腺機能は血清サイロキシン20μg/dl以上, BMR+77.8%, 131I甲状腺摂取率81%と明らかな亢進を示した.その他の内分泌異常として,尿中17KSの軽度低下, GTT時のIRIの過剰反応, ITT時のHGHの低反応,血清LH, FSHの高値およびLH-RH試験におけるLHの高反応などがみられた.入院後, methimazole15mg/日投与により甲状腺機能が正常化すると共に嚥下障害は消失し,徐々に歩行障害は改善し,独力で立ち上がりも可能となつた.以上の経験に加え,文献的にも両者の合併は筋力低下の急速な悪化をもたらすとされており,甲状腺機能亢進症の早期発見,早期治療が肝要である.

Polyacrylamide Disc Electrophoresis of Cerebrospinal Fluid Proteins

近年新しく開発された蛋白分画法の中で, ディスク電気泳動法は, 検体が微量ですみ, 分離能および再現性もすぐれ, 稀薄蛋白液の泳動にも前処置に濃縮を必要としない等の利点を有している. 本法による髄液蛋白分画の研究は, 従来, 使用髄液量を一定とした泳動実験の報告を見るのみであり, 使用髄液蛋白量を一定とした論文は, 本邦にはみあたらない. 我々は泳動する蛋白量を一定にして, 総計386検体の髄液を泳動し, そのうち122検体を疾患別に検討し, 以下に述べる成績を得た.1) 髄液のディスク電気泳動法において, 使用蛋白量を一定 (約200μg) とすることによって, 泳動像およびその蛋白分画相対濃度百分率を, 各検体間でより正確に比較することができた.2) 蛋白分画を大きく5区域にわけた. 正常髄液23検体の各分画相対濃度百分率の平均値および標準偏差は, Pre.-zone: 10.9±2.7%, Alb.-zone: 40.3±5.8%, A-zone: 13.5±1.6%, B-zone: 19.2±3.9%, G-zone: 16.1±2.6%であった. G-zoneの意義については免疫グロブリンとの関係を考察した.3) 疾患により有意の増減 (危険率5%) を認めた分画は, 髄膜炎, 神経梅毒, 脳硬塞, 脳腫瘍, 多発性硬化症および椎間板ヘルニアのいずれの疾患でも, 髄液蛋白量が40mg/dl以上のときは, Pre.-zone の減少とG-zone の増加を認めた. 椎間板ヘルニアでは常にA-zone の増加があり, 髄液蛋白量が40mg/dl以下のとき Alb-zone の減少を認めた. 脳硬塞では, 常に Pre.-zone が減少し, 髄液蛋白量40mg/dl以下のときA-zone は増加した. 髄液蛋白量が40mg/dl以下でも G-zone の増加を認めた疾患は, 多発性硬化症, 脳腫瘍, 椎間板ヘルニアであった.