Although brain lesions have been described in some cases with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), little is known about the nature of brain lesion and its relation to the spinal cord lesion. In the present study, we performed histopathological analysis of the brain and the spinal cord of four autopsied cases with HAM/TSP to clarify the relationship between the brain and the spinal cord lesions. In two cases with active-chronic inflammation in the spinal cord, perivascular inflammatory infiltration was also seen in the brain, and the composition of cell subsets was similar both in the spinal cord and in the brain. No active inflammatory change was seen in the brain in two cases with inactive-chronic spinal cord lesions. Inflamed vessels were distributed mainly in the deep white matter and in the area between cerebral cortex and white matter of the brain. In the spinal cord inflamed vessels were mainly seen in the bilateral lateral and the ventral posterior columns. Parenchymal infiltration was diffused in the spinal cord but very sparse in the brain, suggesting the importance of parenchymal infiltration in the destruction of tissues. These results suggest that inflammatory changes occurred simultaneously in the spinal cord and in the brain, and that distribution of inflamed vessels closely correlated with the characteristics of vascular architecture of the brain and the spinal cord, which lead to a slow blood flow. This study may help promote a better understanding of the pathogenesis of HAM/TSP.

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The addition of morphine 0.2 mg to hyperbaric bupivacaine 0.5% by intrathecal injection reduced postoperative pain and analgesic use, and increased patient satisfaction following cesarean section. The combination of intrathecal injection of morphine and preventive NSAIDs can be easily administered in most hospitals, and is substantially less expensive than the new pain management technologies currently in use.

This study was carried out to analyse if some of the sperm parameters assessed by computer-aided sperm analysis (CASA) are associated with multinucleate formation in human in vitro fertilization (IVF). In the present study, 137 IVF-embryo transfer (ET) treatment cycles in which pronucleate formation could be observed were enrolled. Sperm parameters after swim-up were assessed using CASA and strict criteria. Thirty-two (2.3%) of 1368 oocytes fertilized were judged as multinucleate formation, which occurred in 25 of 137 IVF-ET treatment cycles, giving the incidence of 18.2%. The factors associated with multinucleate formation were analysed. There were significant differences of the numbers of oocytes collected (13.9 vs. 9.2; p=0.028), fertilization rate (88.8% vs. 71.9%; p=0.011), curvilinear velocity (VCL) (162.7 microm/sec vs. 149.1 microm/sec; p=0.034), average path velocity (VAP) (100.3 microm/sec vs. 93.1 microm/sec; p=0.016), and amplitude of lateral head displacement (ALH) (5.9 microm vs. 5.3 microm; p=0.046) between 25 cycles with multipronucleate formation and 112 cycles with two pronucleate formations. However, there were no significant differences of women's age or the number of sperm inseminated between the two groups. These findings suggest that prediction of multinucleate formation in human IVF might be possible in patients when the number of oocytes collected is higher and sperm motility parameters after swim-up are faster. However, prevention of multinucleate formation seems to be unnecessary because a higher successful IVF-ET outcome is expected as a result of the excellent fertilization rate in these patients.

To study the utility of a new computerized motor-skill analyser (CMSA) for evaluating visuo-motor skilled movements of the arm, we examined (1) the reproducibility of measurement with the CMSA for the arm in 13 healthy participants and 14 patients with stroke and (2) the correlation between motor skills of the affected arm evaluated with the CMSA and clinical tests for upper extremity function in 20 patients with stroke. The CMSA for the arm was used to calculate the accuracy in tracking with the hand. The inter-class correlation coefficients for lap time, geometric trajectory error, trajectory error integrated over time and the marker trajectory error integrated over time were 0.45 (NS)-0.91 (P<0.01) in healthy participants and 0.62 (P<0.05)-0.90 (P<0.01) in patients with stroke. The trajectory error integrated over time and the geometric errors of the affected arm in stroke patients were negatively correlated with the Brunnstrom stage and the simple test for evaluating hand function. The marker trajectory error integrated over time in stroke patients was negatively correlated with the simple test for evaluating hand function. These results suggest that the CMSA for the arm is useful for quantitatively evaluating delicate visuo-motor skills of the arm.