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We present here a case of episodic, pure cheiro-oral syndrome caused by a ruptured intracranial dermoid cyst. Cranial magnetic resonance imaging (MRI) using the fat-suppression method revealed a fatty mass lesion in the subarachnoid space of the left parasellar region and multiple lipid droplets in the subarachnoid space over the left perisylvian area. Although no evidence for it pathogenesis was obtained, the patient's cheiro-oral syndrome could have resulted from a transient vasospasm around the left ventral posterior thalamic nucleus or postcentral gyrus.

We report here a case involving a 14-year-old boy who developed acute disseminated encephalomyelitis following live rubella vaccination. The patient became febrile and began to experience nuchal pain 16 days after the immunization. By 22 days after immunization, he experienced difficulty in walking. By 24 days, he had developed tetraparesis with retention of urine, and total sensory loss below the Th1 dermatomal level. He was febrile at this point and showed nuchal rigidity and Lhermitte's sign. Cerebrospinal fluid examination revealed elevated cell counts, protein level, and myelin basic protein. T2-weighted magnetic resonance imaging detected high intensity lesions in the bilateral cerebral white matter and cervical spinal cord. Following the administration of intravenous corticosteroids, the patient's clinical symptoms improved rapidly.

The relation between activation of caspase-8 and polyglutamine aggregates has been focused. We prepared an antiserum (anti-m8D387) that recognizes the active form but not the proform of mouse caspase-8. We used immunostaining with anti-m8D387 antiserum to compare the localizations of activated mcaspase-8 in L929 (clone 1422) cells induced by TNF and polyglutamine aggregates. Anti-m8D387 was positive throughout cytoplasm of the TUNEL-positive cells induced by TNF treatment, whereas the anti-m8D387 reactivity was not positive throughout cytoplasm of the cells expressing polyglutamine but was restricted to polyglutamine aggregates. In contrast with TNF-treated cells, cells expressing anti-m8D387-positive cytoplasmic polyglutamine aggregates did not undergo TUNEL-positive apoptosis. Thus activated caspase-8 associated with polyglutamine aggregates alone was not sufficient to induce TUNEL-positive apoptosis of L929 (clone 1422) cells. The distribution of activated caspase-8 associated with polyglutamine aggregates may be essential for the polyglutamine-mediated cell death or downstream of caspase-8 may be different in the TNF-treated cells and cells expressing polyglutamine., (Copyright 2000 Academic Press.)

A 4-year-old boy showed two episodes of encephalitis/encephalopathy involving disturbed consciousness, convulsion, and paresis associated with the elevated levels of protein and myelin basic protein of the cerebrospinal fluid. MRI studies of the brain revealed symmetrical lesions in the brain stem and thalami at the first episode, and additional lesions were found in the cerebellum involving both the gray and white matter in the second episode. The intensities of MRI lesions were low in T I and high in T2. These episodes were followed by an elevation of the anti-viral antibody titers, for influenza A virus during the first episode and for adenovirus during the second. In the second episode, intravenous methylprednisolone therapy resulted in rapid improvement of his neurological signs.

dy/dy mice, which carry an unidentified mutation in the Lama2 gene, show dystrophic pathologies similar to those of human congenital muscular dystrophy. Laminin alpha2 deficiency induces apoptosis with DNA fragmentation. Caspases, which are involved in various types of cell death, are sequentially activated through a processing by other members of caspases. By using a cleavage site-directed antibody against caspase-3 that specifically reacts with the active form of caspase-3, we immunochemically demonstrated that caspase-3 is activated in the skeletal muscle fiber of dy/dy mice and that some of the activated caspase-3 muscle fibers are TUNEL-positive. Thus the lack of laminin alpha2 signals activates caspase-3, resulting in the apoptosis of muscle fibers., (Copyright 1999 Academic Press.)

We prepared a cleavage site-directed antiserum against Caspase-3 (anti-p20/17), which reacts with the p20/17 fragment (p20/17) activated by cleavage but not proCaspase-3 (p32), and examined the relationship between the activation of Caspase-3 and apoptosis. We identified p20/17-positive cells where cell death occurs naturally: interdigits of the forelimbs, small intestine epithelium, thymus, trigeminal ganglia, and dorsal root ganglia of mouse embryos. Withdrawal of nerve growth factor induced the appearance of p20/17-positive cells with DNA fragmentation in the culture of dorsal root ganglia neurons, while DNA fragmentation was detected in both p20/17-positive and -negative neurons in dorsal root ganglia of mouse embryos. These results suggest that not only activation of Caspase-3 but also other molecular mechanism play a role in the naturally occurring dorsal root ganglia apoptosis. Cleavage site-directed antisera against Caspases will be useful for the analysis of the molecular mechanism of naturally occurring apoptosis during development.

Mutation of the Patched gene has been detected in human inherited basal cell nevus syndrome (BCNS) and sporadic basal cell carcinomas (BCC), suggesting a strong relation between a Sonic hedgehog-Patched signal and cell proliferation. In the present study, we demonstrate that Sonic hedgehog is expressed in human lung squamous carcinoma (LK-2 and EBC-1) and some adenocarcinoma cell lines. The expression of Sonic hedgehog is also detected in the human lung squamous carcinoma tissues, but not in the normal lung tissue of the same patient. The N-terminal region of Sonic hedgehog stimulates the incorporation of BrdU into LK-2 cells and stimulates their cell growth, while anti-Shh-N inhibits their cell growth. These results suggest that a Sonic hedgehog signal is involved in the cell growth of LK-2 cells., (Copyright 1997 Academic Press.)

P19 EC cells undergoes apoptosis during neuronal differentiation induced by retinoic acid. Two CPP32-like proteases, CPP32 and Mch-3, are expressed in untreated and retinoic acid-treated P19 EC cells. CPP32-like activity is remarkably increased in apoptosis during neuronal differentiation of P19 EC cells. Inhibition of CPP32-like proteases prevents apoptosis, suggesting that activation of CPP32-like proteases play central roles in the apoptosis during neuronal differentiation of P19 EC cells. Wortmannin, PI-3K inhibitor, enhances the CPP32-like activity of the retinoic acid-treated P19 EC cells. PI-3K may be involved in the apoptosis during neuronal differentiation as negative regulator.

We isolated mouse CPP32/apopain cDNA, a mammalian homologue most closely related to Ced-3 in C. elegans, and examined the involvement of CPP32 in the apoptosis of nervous system during development. CPP32 is specifically expressed in the trigeminal (V) ganglia, facio-acoustic (VII-VIII) ganglion complex, and dorsal root ganglia (DRGs) of mouse 10.5-day embryos. CPP32-like proteases are activated during apoptosis of DRG neurons induced by deprivation of NGF and serum. Ac-DEVD-CHO, an inhibitor for CPP32-like proteases, prevents apoptosis of DRG neurons, but Ac-YVAD-CHO, an inhibitor for ICE-like proteases, does not. These results suggest that CPP32 or CPP32-like proteases play a role as central mediator in the apoptosis of DRG neurons induced by lack of neurotrophin signals.

Sonic hedgehog (Shh), a homologue of Drosophila hedgehog, was specifically expressed in lung epithelium during branching morphogenesis, but was not uniformly expressed in lung epithelium. Shh was intensely expressed in the distal tips of the bronchial tubes during branching morphogenesis, and Shh was localized on the apical side of the epithelium. On the other hand, Bmp-4, one of the target genes of Shh, was also specifically expressed in the epithelium at the branching point. These results suggest that Shh and Bmp-4 are involved in the branching morphogenesis of lung epithelium.

We report a patient with Miller Fisher syndrome who was treated with an intravenous high-dose of immunoglobulin. This syndrome is considered to be a benign variety of acute inflammatory demyelinating polyneuropathy (Guillain-Barré syndrome). However, there have been several reports of the need for ventilatory support and a few cases have had a fatal outcome. We observed a case of progressive Miller Fisher syndrome in a 3-year-old boy. Following 2 episodes of apnea lasting about 50 s each, he was treated with intravenous immunoglobulin (400 mg/kg/day) for 5 consecutive days. His respiratory state, general muscle strength, truncal ataxia and emotional state improved remarkably after this therapy.

Mitochondrial myopathy, encephalopathy, lactic acidosis and strokelike episode (MELAS) is a major group of heterogeneous mitochondrial disorders. To identify the defective gene, mitochondrial DNA from a patient with MELAS was sequenced by using amplified DNA fragments as sequencing templates. In 14.1 kbp determined out of 16.6 kbp of the whole mitochondrial gene, at least 21 nucleotides were different from those of a control human mitochondrial DNA. One of the substitutions was a transition of A to G in the tRNA(Leu) (UUR) gene at Cambridge nucleotide number 3,243. This nucleotide is conserved not only in many mitochondrial tRNAs but in most cytosolic tRNA molecules. An Apa I restriction site was gained by the substitution of this nucleotide. The Apa I digestion of the amplified DNA fragment revealed that all independent 6 patients had G at nucleotide number 3,243 in their mitochondrial DNAs, but none of 11 control individuals had G at this position. This result strongly suggests that the mutation in the mitochondrial tRNALeu gene causes MELAS.

The gene transfection technique was applied to establish clonal human skeletal muscle cell lines. DNA of a replication origin-defective mutant of SV40 was transfected into a primary culture of human skeletal muscle by the DNA-calcium phosphate co-precipitation method, and myoblast-derived cells were selected from among the transformed cells and cloned. The myogenic clonal cells exhibited an enhanced growth rate and an unlimited life span, which indicated that a stable supply of a large quantity of cultured human myogenic cells without contaminating fibroblasts was possible. In addition, despite the transformation, the transformed clones retained a certain differentiation ability, that is, they could form multinucleated cells or express a muscle-specific isomer of creatine kinase. These characteristics of transformed myogenic cells should be of great value in studies on the molecular pathologies of various myopathies.