Search

To evaluate whether nystagmus has clinical significance in psychiatric patients who have functional and/or organic brain dysfunction. We performed gaze, positional and positioning nystagmus tests on 227 patients with psychiatric diseases (144 men, 83 women, with an average age +/- SD of 62.5 +/- 14.0 years) in order to evaluate the frequency and characteristics of nystagmus. Patients were classified according to the underlying disease. Normal control subjects were 107 subjects (26 men, 81 women, with an average age +/- SD of 35.6 +/- 10.0 years). Nystagmus was observed in 56 (24.7%) of 227 cases. Nystagmus was seen in 16 (59.3%) of 27 cases of alcoholism, 14 (22.2%) of 63 cases of organic psychiatric disorders, 25 (20.2%) of 124 cases of schizophrenia, 1 (20.0%) of 5 cases of excited mental retardation, 0 (0.0%) of 7 cases of mood disorders, 0 (0.0%) of 1 case of anxiety disorders and 1 (0.9%) of 107 subjects of normal control. There was a significant difference between psychiatric diseases and normal control. These results indicate that nystagmus may also be a very important clinical finding not only in patients with neurological and neuro-otological diseases, but also in patients with psychiatric diseases.

To evaluate whether neuro-otological tests have clinical significance in psychiatric patients with nystagmus who have inner ear and/or brain dysfunction, we performed neuro-otological tests on 56 psychiatric patients with nystagmus (38 men, 18 women) (age range 40–97; mean age ± SD 61.6 ± 10.5 years). Patients were classified according to the underlying diseases: schizophrenia (25 cases), organic psychiatric disorders (14 cases), alcoholism (16 cases) and excited mental retardation (1 case). Caloric test results showed a normal response in 30 (75%) cases, right canal paresis (CP) in 4 (10%), left CP in 4 (10%) and bilateral CP in 2 (5%). Therefore, 10 (25%) cases had CP. The results of the eye tracking tests (ETT) were sorted into five categories: 4 (8.2%) cases smooth (normal), 8 (16.3%) slightly saccadic, 28 (57.1%) saccadic, 8 (16.3%) ataxic, and 1 (2%) no tracking ability. Therefore, 45 (91.8%) cases had abnormal ETT results. Pure tone audiometry showed normal hearing in 24 (47.1%) cases, right hearing loss (HL) in 3 (5.8%), left HL in 3 (5.8%) and bilateral HL in 21 (41.2%). Therefore, 27 (52.9%) cases had HL. The patients were classified as organic or functional groups. In ETT there was a significant difference between these two groups. These results indicate that neuro-otological tests with video-oculography are very important not only for neurological or neuro-otological patients with nystagmus, but also for psychiatric patients with nystagmus.

Yokukansan (YKS) is used frequently against behavioral and psychological symptoms of dementia (BPSD) together with donepezil in patients with Alzheimer's disease (AD). Here, we investigated the efficacy and safety of YKS in patients with AD in a non-blinded, randomized, parallel-group comparison study. Patients who had at least one symptom score of four or more on the Neuropsychiatric Inventory (NPI) subscales were enrolled in the study. The subjects were randomly assigned to the YKS-treated group (YKS/donepezil combination therapy group) and the non-YKS-treated group (donepezil monotherapy group). TSUMURA Yokukansan (TJ-54, 7.5g, t.i.d.) was administered in a four-week study treatment period. The subjects were evaluated twice at the start (Week 0) and completion (Week 4) of the study treatment in terms of NPI, Mini-Mental Status Examination (MMSE), Disability Assessment for Dementia (DAD), Zarit Burden Interview, and Self-rating Depression Scale (SDS). The efficacy analysis was performed in 29 patients (YKS-treated group) and 32 patients (non-YKS-treated group). The NPI total score improved significantly more in the YKS-treated group than in the non-YKS-treated group. In the NPI subscales of agitation/aggression and irritability/lability, the YKS-treated group showed significantly greater improvement than the non-YKS-treated group, but no statistically significant improvement was seen with YKS in the other subscales. There were no significant differences between the YKS-treated group and the non-YKS-treated group in MMSE, DAD, Zarit Burden Interview and SDS. No adverse reactions were noted in either group. The results of this study showed that YKS is safe and effective in the treatment of BPSD in AD patients.

Precise immunological recognition of anti-viomycin antiserum at detailed parts in the structure of viomycin was studied by cross reactivities of the antiserum to viomycin and its ten analogs using an enzyme immunoassay of viomycin. The antiserum clearly recognized all minor modifications in the sixteen membered ring of viomycin, indicating that the antiserum clearly recognizes the whole structure of the sixteen membered ring. Recognition of the antiserum on the beta-lysine terminus was also examined showing that the antiserum was also recognized on this part. Thus, the anti-viomycin antiserum was deduced to recognize the whole structure of viomycin, from which the deduction was made that the anti-viomycin antibodies in the antiserum must possess cavities fitting the whole structure of viomycin. The crystal dimensions of viomycin are 13 A in length, 8 A in width, and 7 A in depth. Thus, the high dimensional structure of the binding sites of the anti-viomycin antibodies was deduced to possess cavities of a similar size to that of viomycin.

✓ The clinical course of 50 patients with conservatively treated intracranial arteriovenous malformations (AVM's) was followed, most of them for more than 5 years. The average follow-up period was 13.4 years. The initial symptom was intracranial bleeding in 29 patients (58%) and seizure in 15 patients (30%). Small and deep-seated AVM's were associated with a high incidence of bleeding; however, repeated hemorrhages were not necessarily indicative of a poor prognosis. Children younger than 15 years had a better prognosis than adults. There was no correlation between pregnancy and bleeding. In the hemorrhage group, the incidence of rebleeding was 6.9% in the 1st year after initial rupture, 1.91% per year after 5 years, and 0.92% per year after 15 years. The overall incidence of rebleeding was 34.5% in the hemorrhage group. Of the 50 patients, 37 (74%) had a good clinical outcome, four (8%) had a fair outcome, and four (8%) had a poor outcome; five patients died.

As a basic study to investigate suitable conditions to immunize rabbits with drug-immunogens, two highly sensitive and accurate enzyme immunoassays (EIAs) for specific antibody to viomycin (VM) and blasticidin S (BLS) were developed using the corresponding standard antibody, the solid-phase antigens, and enzyme-labeled goat anti-rabbit immunoglobulin G (IgG) antibody as immunological reagents. The accuracy of the assay results with these newly developed EIAs was demonstrated. The new EIAs as well as two previously developed EIAs, EIA for antibody specific to neocarzinostatin (NCS) and a sandwich EIA for rabbit IgG, were applied for analyses of the changes in contents of total and specific antibodies in rabbit antisera samples collected during immunizations with four antigens. Total IgG levels increased from 7.0-9.9 mg/ml to 30-50 mg/ml in all rabbits immunized under the same immunizing schedule, despite the use of four kinds of antigens. The highest level of specific antibodies, anti-BLS, anti-VM and anti-NCS, was 0.5 mg/ml in each case.

Affinty purification procedures for antibodies specific to a drug and to a carrier protein were examined in detail with the use of three enzyme immunoassays (EIAs). Many blasticidin S (BLS) molecules were coupled to an affinity ligand with pig serum albumin as a spacer protein. The influence of the spacer on the affinity purification of an antibody specific to BLS was quantitatively analyzed. The antibody showed higher binding to BLS bound to the solid matrix with a carrier protein than without. The stability of specific antibody in six representative eluents, used for affinity chromatography of specific antibodies, was examined, and 0.1 M potassium chloride-0.008 N hydrochloric acid buffer was selected as the preferred eluent based on the stability of the specific antibody and convenience in handling. The ability of the buffer to elute the specific antibody from an affinity column was studied, and was improved by modifying the concentration of potassium chloride in the buffer to 0.3 M. Complete purification of anti-BLS antibody was performed by affinity chromatography under the chosen conditions. The specific anti-BLS and anti-carrier protein antibodies were purified quantitatively. Formation of denatured specific antibody was hardly detected by a sensitive ETA, under the chosen conditions. The purity of the standard antiBLS antibody was demonstrated by the affinity chromatographic method with the aid of two EIAs for rabbit immunoglobulin G and for BLS.

A quantitative enzyme immunoassay (EIA) for specific antibody to neocarzinostatin (NCS) is described which uses enzyme-labeled anti-rabbit IgG antibody, solid-phase NCS and standard purified specific antibody to NCS. The dose of the standard was determined by sandwich EIA for rabbit IgG. The lower detection limit was 3 ng of the specific antibody per tube. The accuracy of the assay was excellent and a comparative study with the sandwich EIA for rabbit IgG showed good correlation. The antiserum to NCS of the highest titer was found to contain 0.6 mg and 40 mg per ml of specific antibody to NCS and of normal IgG, respectively. The accuracy of the assay results and the purity of the standard was established by 2 recovery tests for anti-NCS antibody.

A new viomycin-bovine serum albumin conjugate was characterized, and 19 viomycin molecules were found to be coupled with one molecule of the carrier protein. Enzyme labelling of viomycin with β-D-galactosidase was performed by a continuous two-step process using a maleimide succinimidyl ester type cross-linker. The optical conditions for enzyme immunoassay of viomycin using the new anti-viomycin antiserum and the enzyme labelled viomycin (double antibody method) were studied and a procedure with satisfactory accuracy and precision was developed. The specificities of two anti-viomycin antisera were compared by the enzyme immunoassay technique. Evidence that the enzyme immunoassay procedure is preferable to radioimmunoassay for a comparative study is also presented.