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T-cell responses to pathogenic free-living amoebae, Acanthamoeba sp., were analyzed in healthy Japanese individuals. Of 20 healthy subjects, 10 (50%) showed significant proliferative responses of peripheral blood mononuclear cells to the soluble amoebic antigens in vitro. The antigens used were not mitogenic, and no evidence of amoebic superantigens was available. We established human T-cell clones reactive to Acanthamoeba, all of which were CD3- and CD4-positive, CD8-negative, and TCR-alpha beta-positive. We isolated two strains of Acanthamoeba from two patients, one from a patient with meningoencephalitis (CSF strain) and the other from a patient with keratitis (K strain). Of 13 clones, 11 were reactive to the K-strain as well as to the CSF-strain antigen under human leukocyte antigen (HLA)-DR restriction, whereas the other two were specific for the K-strain antigen. All but one clone tested showed TH1-equivalent functions because these cells produced interferon (IFN)-gamma in response to the amoebic antigen but produced no detectable level of interleukin 4 (IL-4). These results suggest that immunocompetent hosts might have acquired protective immunity mediated by Acanthamoeba-specific T-cells during natural sensitization.

To investigate the relationship between oxidative stress and apoE phenotype in dementia of Alzheimer type (DAT).Hydroxyl radical content in blood, superoxide dismutase (SOD) activity in red blood cells (RBC) and plasma, Cu,Zn-SOD protein content in RBC, and apoE phenotype were determined in 24 DAT patients and 25 controls.DAT patients with the apoE4 phenotype showed higher hydroxyl radical levels than DAT patients without the apoE4 phenotype or controls. SOD activities and Cu,Zn-SOD protein levels in RBC of DAT patients with and without the apoE4 phenotype showed no significant differences, but values in both patient groups were lower than in controls. The apoE4 phenotype was more prevalent in DAT patients than in controls. DAT patients with the apoE4 phenotype were younger at disease onset than DAT patients without the apoE4 phenotype.Our findings suggest that apoE4 and SOD individually influence oxidative stress in DAT.

Povidone-iodine (PVP-I) is generally very safe, but cases of thyroid dysfunction induced by PVP-I have been reported. The effect of long-term treatment with PVP-I on thyroid function was to be assessed. In 40 inpatients of the department of neurology, the status of the use of PVP-I preparations and their effects on serum inorganic iodine levels and thyroid functions were investigated. In 27 patients treated with PVP-I for a long term, inorganic iodine levels were significantly increased as compared to those in 13 patients without PVP-I treatment. Out of 27 patients treated with PVP-I in the long term, subclinical hypothroidism was seen in 3 patients, mild hyperthroidism was seen in 1 patient, and subclinical hyperthyroidism was suspected in 7 patients. Patients treated with PVP-I for a long time should be observed carefully for any manifestation of thyroid dysfunction.

We studied free radical, lipid peroxide (LPO) and antioxidant levels of blood in three cases with mitochondrial encephalomyopathy. Case 1 was a 17-year-old man with MELAS. Serum vitamin E levels were decreased and LPO levels were increased after stroke-like episodes in case 1. Case 2 was a 68-year-old woman with MELAS and a maternal elder aunt of case 1. She showed an elevated serum LPO levels (6.58 nmol/ml) in the absence of stroke-like episode and serum CoQ10 level was 0.54 microgram/ml before therapy. By CoQ10, idebenone and tocopherol nicotinate therapy, serum LPO levels decreased gradually in parallel with the decrease of lactate and pyruvate levels. Free radicals were measured in case 2 and controls by spin trapping method. Hydroxyl radical and C center radical were increased and H radical was normal in blood. But these free radicals in serum were all normal. Her serum antioxidants revealed an elevated percent inhibition of SOD and a decreased transfferin level. Case 3 was a 52-year-old woman with MERRF. She showed an elevation of serum LPO (12.8 nmol/ml). Her serum antioxidants revealed an elevated vitamin E and ceruloplasmin levels and percent inhibition of SOD.

We investigated the incidence of convulsions observed during treatment with antidepressants. Among the patients observed in this department, 582 cases received the antidepressants for more than 2 months were selected. 8 cases (1. 4%) of these patients showed convulsions. Detailed evaluation revealed a high incidence of convulsions occurred in patients who were administered more than two kinds of antidepressants. Among tetracyclic antidepressants, viz. maprotiline and clomipamine, and tricyclic antidepressants, viz. amitriptyline indicated a high incidence rate of convulsions. On the contrary, mianserin and imipramine tended to show a lower incidence. In 4 cases, acute toxic symptoms were seen before the convulsion, and the serum concentration of antidepressants in these patients was high. If toxic symptoms and elevated level of serum concentration are useful indicator for prediction of convulsion by treatment with antidepressants, these might be a noteworthy clinical findings. At present, if doctors are required to administer more than moderate amounts of more than two antidepressants, careful administration is desirable. With the accumulation of such cases, it is necessary to obtain further evaluation of the relationship between toxic symptoms and serum concentration of antidepressants.

Epidemiological investigation of senile dementia was performed in 1987 and 1988 on all the aged at home (3,754 persons at the ages of 65 years or more) in Miki-cho (M-cho), Kagawa Prefecture. The composition of the population in M-cho is similar to that in Kagawa Prefecture. M-cho has the most population among the towns or villages in Kagawa Prefecture. Urban areas, rural areas, and middle areas are distributed evenly in respect to the size in M-cho. Thus, it was possible to carry out the investigation reflecting the situation in Kagawa Prefecture. The results of the present investigation were as follows. 1) The prevalence rate was 4.1% in both the first year (1987) and the second year (1988). 2) The incidence rate was 1.01%. 3) The proportion of Alzheimer type dementia to cerebrovascular type dementia was 0.98 in the first year and 1.00 in the second year. 4) Although no statistically significant difference in the prevalence rate was noted between males and females, the prevalence rate of males was higher than that of females in the first half of senility, and the prevalence rate of females was higher than that of males in the second half of senility. 5) Although no statistically significant difference in the prevalence rate was noted between Alzheimer type dementia and cerebrovascular type dementia, the prevalence rate of cerebrovascular type was higher than that of Alzheimer type in the first half of senility, and the prevalence rate of Alzheimer type was higher than that of cerebrovascular type in the second half of senility. The epidemiological investigations of senile dementia have been often reported in all over the world. However, most of the investigations were made on nothing but the calculation of the prevalence rate of senile dementia, while the investigation of the incidence rate was hardly carried out. In respect to the incidence rate, it is desirable that the subjects should be more than 1,000 in number. When the number of subjects is less than 1,000, the occurrence of senile dementia will be noted yearly in approximately 10 cases. If the number of patients with senile dementia increases or decreases even by one, therefore, the incidence rate differs to a great extent. The past reports on the incidence rate were made in subjects of less than 1,000 in number. Accordingly, it may be possible to say that the present investigation was made by the exact methods accompanied by less errors.(ABSTRACT TRUNCATED AT 400 WORDS)

This is a report of two middle-aged women whose diagnosis of PHPT was made on hypercalcemia during treatment of depression and paranoid state, leading to the surgical confirmation of parathyroid adenoma. After the operation, their mental symptoms disappeared as the blood level of calcium was depressed in both cases, and there has been no recurrence for 12 and 18 months, respectively. In Case, 1 antipsychotics were effective, though transiently, for the mental symptoms other than physical ones. In Case 2, levodopa and hypercalcemia might have acted synergistically. Abnormal metabolism of magnesium was not noted in either case. A preoperative EEG showed the presence of sporadic slow waves in Case 1 and low voltage activity in Case 2. After the operation, the EEG showed an improvement to regular hypersynchronous alpha activity in both cases. The mechanism involved in the appearance of mental symptoms and EEG findings in hypercalcemia were discussed.