We measured metabolites of tyrosine and tryptophan (TRP) in the frontal cortex, putamen (PT), and pars compacta of the substantia nigra (SN) of control and Parkinson's disease (PD) brain tissues. Dopamine concentrations were significantly decreased in the PT and SN of PD tissue, regardless of L-dopa therapy. However, 3-O-methyldopa (3OMD) concentration showed a significant increase in each region of the PD group treated with L-dopa (PD[+]) as compared with both the control group and the PD group without L-dopa therapy (PD[-]). Therefore, 3OMD concentration appears to be a reliable marker of L-dopa therapy. Serotonin concentration was lower in each region of the PD groups than in the control group. Although the magnitude of decrease was greater in the PD(+) group, there was no statistical significance between the two PD groups. The same patterns of decrease were present in kynurenine (KYN) and kynurenic acid (KYA) concentrations, but the molar ratios of TRP to KYN and KYN to KYA were unchanged among three groups. In contrast, 3-hydroxykynurenine (3OHKY) concentration was increased in the PT PD(-) group and in three regions of the PD(+) group. Since the KYN pathway leads to formation of nicotinamide-adenine dinucleotide (NADH), the present results may be a further indication of a defect in NADH:ubiquinone oxidoreductase (complex I) in mitochondria in PD.

This study examined the effects of hand and spatial conditions on a visual line bisection task with normal right-handers and proposed a normal range of deviation for this task in middle and advanced age. Twentyfour normal dextrals in their fifties and sixties performed a visual line bisection task using either the left or right hand under three spatial conditions : at the midline and in the left and right hemispaces. Our results revealed that performance was significantly affected by the hand used but not spatial conditions : Left hand performance was significantly further leftward than right hand performance. There was no significant interaction between the hand and spatial conditions. The mean deviation of the right hand was 2.2% of the half line length to the right of the true center. The possibility of left unilateral spatial neglect should be considered if a patient bisects a line with a deviation greater than 10% of the half line length to the right, line bisection ; normal range ; effect of used hand ; effect of hemispace The visual line bisection task is a common test for detecting unilateral spatial neglect (USN). When required to bisect a horizontal line, patients with left USN are expected to mark the midpoint to the right of the true center, because they neglect the left side of the line.There have only been a few studies on the performance of a visual line bisection task in normal subjects. Schenkenberg et al. (1980) had 20 hospitalized, non-neurological, right-handed control patients bisect lines and reported that they had a tendency to bisect lines o the left of center when using their left hand, and on or slightly to the right of center when using their right hand. Bradshaw et al. (1985) found that normal students using their right hand demonstrated a significant tendency to bisect to the left of the true center on both a visual line and a tactile rod bisection task. Ferro et al. (1987) studied 14 normal controls and concluded that the subjective midpoint were slightly deviated to the left of the

Carcinosarcoma of the bladder is an unusual malignancy characterized by an intimate admixture of malignant epithelial elements (carcinoma) and malignant soft tissue elements (sarcoma). To our knowledge, almost 80 cases have been reported, usually as case reports or small series. Patient with carcinosarcoma usually present with a high stage malignancy. Cystectomy or transurethral resection is the preferred treatment, often followed by radiation therapy, although prognosis is very bad. We herein report a case of carcinosarcoma of bladder obtained pathologically complete response by neoadjuvant chemoradiotherapy. She now shows no evidence of disease 30 months after the operation. To our knowledge, it is the first case where urinary bladder carcinosarcoma obtained a pathologically complete response by chemoradiotherapy.

Sixteen cases with carpal tunnel syndrome (CTS) were reported out of 412 patients on long-term hemodialysis due to chronic renal failure. Clinical symptoms included numbness in the area innervated by the median nerve in 100% of symptomatic hands and pain in the wrist and hand in 81%. This pain usually became severer at night and during hemodialysis. Muscle atrophy was noted in 41% of the hands. Nerve conduction studies revealed prolonged distal sensory latency, slowed sensory nerve conduction velocity across the wrist and normal distal motor latency in 18%, prolonged distal motor latency in 51% and no response in motor or sensory stimulation in 31%. Evidence of denervation on electromyography was seen in 36% of the hands. Patients were conservatively treated avoiding daily activities precipitating the condition with volar wrist splint only at night in 18% and in 90% with steroid hormone injection in the carpal tunnel. Median nerve release was performed in 18% of the hands. Amyloid deposit was demonstrated in 3 of 4 operated hands. Although the relation between long-term hemodialysis and the occurrence of the amyloid deposition in the carpal tunnel has not been established, the present data along with other recent reports strongly indicate that amyloid deposit in the carpal tunnel on hemodialysis patients could be one of the most possible cause of CTS.carpal tunnel syndrome ; entrapment neuropathy ; hemodialysis ; electrodiagnosis Carpal tunnel syndrome (CTS), the most common entrapment neuropathy of the median nerve at the wrist, frequently causes severe pain, undurable numbness and muscle atrophy in the hand intrinsic muscles (Kimura and Ayyar 1985). This syndrome affects predominantly obese, middle-aged, menopausal women. Recently similar symptoms were noted in the patients on long-term hemodialysis due to chronic renal failure. Neurological complications in patients with renal failure and hemodialysis are well-known. Among them peripheral nerve involve-

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