We describe MR findings in patients with Minamata disease who have been followed for a long time. All patients examined were affected after daily eating of a large quantity of methylmercury-contaminated seafood, from 1955 to 1958, and showed typical neurological findings. On MR images, the visual cortex, the cerebellar vermis and hemispheres, and the postcentral cortex are significantly atrophic in Minamata disease. The visual cortex is slightly hypointense on T1-weighted images and hyperintense on T2-weighted images, probably representing the pathologic changes of status spongiosus. MRI can demonstrate the lesions located in the calcarine area, cerebellum, and postcentral gyri, which are probably related to three of the characteristic manifestations of this disease: the constriction of the visual fields, ataxia, and sensory disturbance, respectively.

Atrophy↗

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Lymphocytic infiltrations in the lung of two autopsy cases with HTLV-I-associated myelopathy.

Pulmonary involvement in two autopsy cases with HTLV-I-associated myelopathy (HAM) was observed histopathologically and immunohistochemically. Case 1 was a 59-year-old woman who fell ill after having a blood transfusion, and died immediately of acute heart failure. Case 2, a 55-year-old man, died of pelvic tumor after a long period of steroid medication for the myelopathy. Histologically, in case 1, the submucosal stroma of bronchioles was thickened with T-lymphocyte infiltration. In addition, clusters of B-lymphocytes were aggregated beneath the epithelial layer of respiratory bronchiole; the alveolar septum was infiltrated with a few T-lymphocytes. Furthermore, many B-lymphocytes were aggregated in the submucosal stroma of large bronchi. On the other hand, obvious pathological changes were not seen in the lung tissues of case 2. The long period of steroid medication may account for the fewer findings in case 2. These results present the possibility that latent inflammatory changes develop in the lung of HAM patients, although clinical manifestations are not obvious, and that steroid therapy can modify those inflammatory changes.

Abdominal Neoplasms↗

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In vitro angiotensin-converting enzyme and interleukin-1 production by epithelioid cells isolated from induced rabbit lung granuloma.

We attempted in this experiment to culture epithelioid cells isolated from granuloma induced in the lung of female rabbits that had been injected intravenously with Freund's complete adjuvant. The morphologic findings of isolated cells included abundant rough-surfaced endoplasmic reticulum, mitochondria, Golgi complexes, electron-dense lysosomes, and numerous cytoplasmic processes on the cell surface. Enzymatically these cells were positive for acid alpha-naphthyl acetate and beta-galactosidase staining. These findings coincided with the expected morphologic and enzymatic characteristics of epithelioid cells examined in vivo. Cells isolated from this granuloma are thought to be more than 86% epithelioid cells. Additionally, 14.4 +/- 4.3% of the epithelioid cells showed phagocytosis of latex beads, low when compared with the 83.9 +/- 5.2% value of alveolar macrophages obtained from rabbits injected with adjuvant 4 weeks before sacrifice. The isolated epithelioid cells were incubated for 24 h without decrease in cell population. Their culture supernatants showed 1.86 +/- 0.38 units/ml of angiotensin-converting enzyme (ACE) activity, which was inhibited by cycloheximide. The culture supernatants also showed interleukin-1 (IL-1) activity levels of 6411 +/- 914 cpm without lipopolysaccharide (LPS) stimulation. This increased to 21,766 +/- 3026 cpm with LPS stimulation. In view of these results, we believe it is possible to incubate epithelioid cells for up to 24 h during which time they will produce ACE and IL-1 in the culture supernatants.

Animals↗

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MR imaging of minamata disease: qualitative and quantitative analysis.

Minamata disease (MD), a result of methylmercury poisoning, is a neurological illness caused by ingestion of contaminated seafood. We evaluated MR findings of patients with MD qualitatively and quantitatively. Magnetic resonance imaging at 1.5 Tesla was performed in seven patients with MD and in eight control subjects. All of our patients showed typical neurological findings like sensory disturbance, constriction of the visual fields, and ataxia. In the quantitative image analysis, inferior and middle parts of the cerebellar vermis and cerebellar hemispheres were significantly atrophic in comparison with the normal controls. There were no significant differences in measurements of the basis pontis, middle cerebellar peduncles, corpus callosum, or cerebral hemispheres between MD and the normal controls. The calcarine sulci and central sulci were significantly dilated, reflecting atrophy of the visual cortex and postcentral cortex, respectively. The lesions located in the calcarine area, cerebellum, and postcentral gyri were related to three characteristic manifestations of this disease, constriction of the visual fields, ataxia, and sensory disturbance, respectively. MR imaging has proved to be useful in evaluating the CNS abnormalities of methylmercury poisoning.

Ataxia↗

PubMedDate not supplied

Representation of the visual field in the striate cortex: comparison of MR findings with visual field deficits in organic mercury poisoning (Minamata disease).

PURPOSE: To compare MR imaging findings of the striate cortex with visual field deficits in patients with Minamata disease and to reestimate the classical Holmes retinotopic map by using the data obtained from comparing visual field abnormalities with degree of visual cortex atrophy. METHODS: MR imaging was performed in eight patients with Minamata disease who had been given a full neuroophthalmic examination, including Goldmann dynamic perimetry. The atrophic portions of the calcarine area were measured in the sagittal plane next to the midsagittal image and represented as a percentage of atrophy of the total length of the calcarine fissure. MR findings were compared with results of a visual field test. RESULTS: The visual field test revealed moderate to severe concentric constriction of the visual fields, with central vision ranging from 7 degrees to 42 degrees (mean, 19 degrees). The ventral portion of the calcarine sulcus was significantly dilated on MR images in all patients. A logarithmic correlation was found between the visual field defect and the extent of dilatation of the calcarine fissure. The central 10 degrees and 30 degrees of vision seemed to fill about 20% and 50% of the total surface area of the calcarine cortex, respectively. CONCLUSION: Visual field deficits in patients with Minamata disease correlated well with MR findings of the striate cortex. Our data were consistent with the classical Holmes retinotopic map.

Atrophy↗