Parkinson’s disease (PD) and autism are prevalent diseases in two disparate age groups. The neuropathology underlying these diseases involves the major neurotransmitters, dopamine and GABA, and/ or their receptors. The current study investigated mRNA gene expressions of the GAD67 in autistic striatum and the DRD1 in the Parkinsonian dorsolateral prefrontal cortex. In situ hybridization histochemistry for GAD67 mRNA levels in postmortem striatal specimens from autistic individuals was compared to those of normal controls. Similarly, a nonradioactive in situ hybridization newly emerging method, RNAscope, was used to assess the D1 receptor mRNA gene expression in postmortem specimens of the dorsolateral prefrontal cortex of PD and control brains. The GAD67 mRNA labeling intensity that was measured on X-ray films and on emulsion radioautograph sections did not vary significantly between the autistic samples and the normal control samples. On the other hand, DRD1 mRNA levels showed a significant increase in the Parkinsonian dorsolateral prefrontal cortex specimens as compared to their normal counterparts. The GAD65 mRNA labeling results corresponded with the GAD67 mRNA levels. The similar GAD67 and GAD65 mRNA patterns in the autism group and the control group may suggest that the hyper-excitability hypothesis can be accounted for by an increase in the glutamatergic activity rather than a decrease in the GABAergic system. The increase in the DRD1 mRNA in the Parkinson’s disease dorsolateral prefrontal cortex may be interpreted in light of the expected upregulation of the D1 receptor in cases of dopamine depletion as the treatment-status was unknown. In conclusion, research investigating the neurotransmitters’ gene expression in Parkinson’s disease and in autism spectrum disorder needs more neurobiological studies in order to establish some knowledge regarding the temporality, and the genetic profile mapping of the diseases. Likewise, more research is encouraged to relate the symptoms and behaviors associated with disease to their anatomical origins.

Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / A doenÃa de Parkinson (DP) à uma desordem neurodegenerativa, caracterizada pela destruiÃÃo dos neurÃnios nigroestriatais dopaminÃrgicos. O tratamento atual para esta doenÃa està restrito ao alÃvio sintomÃtico, porque atà o presente momento nÃo existem agentes capazes de inibir a degeneraÃÃo neuronal. Existem evidÃncias experimentais de que antagonistas de receptores A2A da adenosina poderiam ser Ãteis no tratamento de DP. Com a finalidade de investigar essa possibilidade, o presente trabalho demonstrou os efeitos da cafeÃna e do CSC (8-(3-chlorostyryl caffeine) no comportamento rotacional e nas alteraÃÃes neuroquÃmicas em ratos lesionados com 6-OHDA, como modelo da doenÃa de Parkinson. Os animais (ratos Wistar machos, 250-280g) foram tratados com cafeÃna (10 e 20 mg/kg, i.p.) diariamente durante 14 dias, iniciando 1h apÃs a lesÃo ou 7 dias, iniciando seis dias apÃs a lesÃo com 6-OHDA ou com CSC (1 e 5 mg/kg, i.p.) diariamente durante 7 dias, iniciando 6 dias apÃs a lesÃo com 6-OHDA, sozinho ou associado com L-DOPA (CSC 1 mg/kg, i.p. + L-DOPA 50mg/kg + Benzerazida 12,5 mg/kg, i.p.). Os resultados mostraram que houve um aumento significativo do nÃmero de rotaÃÃes induzidas por apomorfina nos animais lesionados com 6-OHDA (50 vezes) quando comparados aos animais falso operados. O tratamento com cafeÃna, principalmente durante 14 dias e o tratamento com CSC produziram uma recuperaÃÃo motora parcial com reduÃÃo do nÃmero de rotaÃÃes. A 6-OHDA provocou morte neuronal evidenciada pela reduÃÃo dos nÃveis de monoaminas (75-85%) quando comparadas ao lado contralateral. Nos grupos tratados com cafeÃna ou CSC sozinho ou associado com L-DOPA a reduÃÃo dos nÃveis de DA, 5HT e seus metabÃlitos foi menor. As concentraÃÃes dos aminoÃcidos glutamato e GABA foram significativamente aumentadas (3,8 e 3 vezes, respectivamente) no estriado de ratos lesionados. O CSC reverteu essas alteraÃÃes significativamente e foi observada uma potencializaÃÃo desses efeitos na associaÃÃo com L-DOPA. Os experimentos in vitro demonstraram que a cafeÃna e o CSC apresentaram um forte efeito neuroprotetor nas cÃlulas mesencefÃlicas de rato expostas a 6-OHDA. O tratamento com CSC ou cafeÃna aumentou significativamente o nÃmero de cÃlulas viÃveis apÃs a exposiÃÃo das cÃlulas a 6-OHDA, como foi demonstrado pelo teste do MTT. A exposiÃÃo das cÃlulas mesencefÃlicas a 6-OHDA aumentou os conteÃdos de nitrito e a peroxidaÃÃo lipÃdica, que retornaram a concentraÃÃes normais apÃs tratamento com CSC ou cafeÃna. AlÃm disso, a 6-OHDA reduziu o nÃmero de cÃlulas normais e aumentou o nÃmero de cÃlulas apoptÃticas e o tratamento com CSC ou cafeÃna reverteu esses efeitos da 6-OHDA, promovendo aumento do nÃmero de cÃlulas viÃveis e reduÃÃo do nÃmero de cÃlulas apoptÃticas. Houve uma reduÃÃo do nÃmero de microglias ativadas apÃs a exposiÃÃo das cÃlulas a cafeÃna e a 6-OHDA, o mesmo nÃo ocorreu apÃs a exposiÃÃo das cÃlulas ao CSC e a 6-OHDA. O tratamento com cafeÃna reduziu o aumento do nÃmero de astrÃcitos reativos induzidos pela 6-OHDA, enquanto o CSC nÃo apresentou esse efeito. Esses resultados mostraram que ambos, a cafeÃna e o CSC apresentaram aÃÃes neuroprotetoras em cÃlulas mesencefÃlicas de rato expostas a 6-OHDA. O presente trabalho mostrou que a cafeÃna e o CSC reverteram Ãs alteraÃÃes comportamentais e neuroquÃmicas da 6-OHDA, apresentando efeitos possivelmente benÃficos no tratamento da DP. / Parkinson disease (PD) is a neurodegenerative disorder characterized by loss of dopaminergic neurons in the substantia nigra pars compacta. Antagonists of the A2A subtype of adenosine receptor have emerged as a target for nondopaminergic antiparkinsonian agents. The present work showed the effects of caffeine and 8-(-3-chlorostyryl)-caffeine (CSC), A2A receptors antagonists, on behavior and biochemical alterations in 6-OHDA-lesioned rats, as a model of PD. Animals (male Wistar rats, 260-280 g) were injected daily with caffeine (10 and 20 mg/kg,i.p., 1h after 6-OHDA lesion for 14 days or six days after 6-OHDA lesion for 7 days), or CSC (1 and 5 mg/kg, i.p., 1h after 6-OHDA lesion for 7 days) alone or associated with L-DOPA (CSC 1 mg/kg, i.p. + L-DOPA 50mg/kg + Benzerazida 12,5 mg/kg, i.p., six days after 6-OHDA lesion for 7 days). Fourteen days after 6-OHDA, the animalsâ behavior was assessed by monitoring body rotations induced by apomorphine (3 mg/kg, i.p.). The results showed that the drastic increase in body rotation, induced by the 6-OHDA lesion, after the apomorphine challenge, was significantly (50 times) and dose-dependently reversed by CSC or caffeine. The decreased striatal levels of DA and metabolites, in the 6-OHDA-lesioned rats (75-85%), were blocked after caffeine or CSC alone or in association with L-DOPA treatment as well as the concentrations of NE, 5-HT and 5-HIAA. These effects were potentiated in 6-OHDA-lesioned animals treated with the association of CSC and L-DOPA. Concentrations of the amino acids glutamate and GABA were significantly increased (3.8 and 3 times, respectively) in the 6-OHDA-lesioned rat striatum. Similarly, CSC also reversed these alterations significantly. We also demonstrated protective effects against 6-OHDA-induced cytotoxicity in rat mesencephalic cells. Caffeine or CSC significantly increased the number of viable cells after their exposure to 6-OHDA, as measured by the MTT assay. While nitrite levels and lipid peroxidation in the cells were drastically increased by 6-OHDA, its concentration was brought toward normality after caffeine or CSC. 6-OHDA decreased the number of normal cells while increasing the number of apoptotic cells. Caffeine or CSC, significantly recovered the number of viable cells, and decreased the number of apoptotic cells, as compared to the group treated with 6-OHDA alone. Interestingly, while a significant lower number of activated microglia was seen after cells exposure to caffeine plus 6-OHDA, this was not the case after cells exposure to CSC plus 6-OHDA. While caffeine lowered the percentage of reactive astrocytes increased by 6-OHDA, CSC showed not effect. These results showed a strong neuroptrotection afforded by caffeine or CSC on rat mesencephalic cells exposed to 6-OHDA. In conclusion, we showed that CSC or caffeine reversed behavior and biochemical alterations, observed in the 6-OHDA-lesioned rats, pointing out to the potential benefit of A2A receptors antagonists as non-dopaminergic therapeutic targets for the treatment of PD.

Les noyaux de la base forment un système de noyaux sous-corticaux interconnectés jouant un rôle majeur dans le contrôle moteur, les processus motivationnels et l’interaction sociale. La principale structure d’entrée de ce système est le striatum. Celui-ci se compose d’une partie ventrale, appelée aussi Nucleus Accumbens (NAc), et d’une partie dorsale. Le striatum ventral joue un rôle essentiel dans les processus motivationnels et de récompense. Cette structure a été intensément étudiée pour ses fonctions dans la récompense et le renforcement associés aux drogues mais elle est également impliquée dans le phénomène de récompense à des éléments naturels tels que la nourriture, le sexe ou les interactions sociales. Le striatum dorsal se divise en plus en une partie latérale, appelée striatum dorso-latéral (DLS) et impliquée dans la formation d’habitudes, et en une partie médiale, appelée striatum dorso-médian (DMS), impliquée dans l’apprentissage moteur et les actions dirigées vers un but. Le striatum est principalement composé des neurones GABAergiques épineux de taille moyenne striatopallidaux (iMSNs) et striatonigraux (dMSNs) qui se caractérisent par des sites de projection spécifiques et l’expression de récepteurs différents. Ces deux populations donnent naissance respectivement à la voie indirecte ou inhibitrice et la voie directe ou activatrice. De nombreuses recherches ont eu pour objectif d’étudier l’implication du striatum, et en particulier du NAc, dans un comportement social primordial, le comportement sexuel. L’implication du NAc dans la facilitation de ce comportement a ainsi pu être mise en évidence mais aucune étude n’a encore abordé le rôle des deux voies. Le but de ce travail de thèse a donc été de mettre en évidence le rôle respectif des iMSNs et dMSNs des différentes régions du striatum dans le comportement sexuel, ainsi que le rôle de la voie directe dans le syndrome autistique. Dans ce but, nous avons utilisé des souris transgéniques exprimant le récepteur simien à la toxine diphtérique (DT) spécifiquement dans l’une ou l’autre des deux populations du striatum. Après injection stéréotaxique de DT dans la région du striatum ciblée chez ces lignées, une ablation spécifique de la population visée a été induite. Grâce à cette approche, nous avons ainsi pu démontrer que les dMSNs du NAc jouent un rôle majeur dans la motivation sexuelle. En effet, les différents paramètres permettant de mesurer cette motivation ont montré une détérioration importante de celle-ci suite à leur ablation. Cette approche nous a également permis de mettre en évidence le rôle des dMSNs du DMS dans la phase d’initiation du comportement sexuel et celui des dMSNs du DLS dans la phase plus tardive de ce comportement. De plus, l’ablation des iMSNs dans le NAc et le DLS nous a permis de montrer le rôle opposé de ces deux régions du striatum dans les performances sexuelles. En effet, l’ablation de ces neurones dans le NAc a induit une amélioration des performances sexuelles chez les mâles, contrairement à l’ablation réalisée dans le DLS. La seconde partie de cette thèse avait pour but de comprende le rôle des dMSNs dans les troubles du spectre autistique (TSA) par l’utilisation de tests comportementaux spécifiques, nous permettant de démontrer l’importance des dMSNs du NAc dans le développement de ces troubles. En effet, les tests comportementaux réalisés chez les souris présentant une ablation des dMSNs dans le NAc ont montré une réduction significative des interactions et des capacités sociales chez ces animaux. De plus, nous avons mis en évidence le rôle de ces neurones dans un autre comportement caractéristique des TSA, le développement de comportements répétitifs. Ces comportements se sont, effectivement, vus augmentés suite à cette ablation neuronale. Enfin, une augmentation de l’anxiété, un symptôme fréquemment associé aux TSA, a pu être démontré chez les animaux lésés. Les souris présentant une ablation des dMSNs du NAc récapitulent donc certaines des caractéristiques d’un modèle murin de TSA.En conclusion, les données obtenues au cours de cette thèse ont démontré l’importance des deux populations neuronales du striatum dans des comportements sociaux physiologiques, tels que le sexe ou les interactions sociales, mais également dans des pathologies telles que les troubles du spectre autistique. / Doctorat en Sciences biomédicales et pharmaceutiques (Médecine) / info:eu-repo/semantics/nonPublished

Synaptic transmission occurs as a result of either a spontaneous release of presynaptic vesicles or a batch release of presynaptic vesicles driven by action potentials. The physiological consequence of synaptic transmission driven by different patterns and frequencies of presynaptic stimulation has been extensively investigated. However, the physiological nature, mechanism as well as relevance of prolonged presynaptic stimulation have been poorly characterized. In this dissertation, I present three projects in which prolonged stimulation of synaptic transmission in different forms and different brain regions was studied for its effect on synaptic transmission, mechanisms and physiological relevance. In the first project, prolonged electrical stimulation (100 sec) at high frequency induced a deep synaptic depression in acute hippocampal slices, followed by a recovery of synaptic transmission after ~15 min. The deep synaptic depression was attributed to a complete depletion of presynaptic vesicle pools. In the second project, attempts were made to characterize the mechanism of nuclear activation of gene transcription induced by prolonged electrical stimulation (100 sec). Our results demonstrated that reduced inactivation of non-L-type calcium channels failed to provide calcium required for gene transcription, leaving the activation of gene transcription a selective function for L-type calcium channels. In the third project, we sought to study the physiological relevance of enhanced miniature events of inhibitory synapses induced by prolonged chemical stimulation. We showed that prolonged application (2 min) of nicotine to the striatal slice enhanced the frequency of miniature inhibitory currents that was accompanied with a reduction in the amplitude of evoked response. This reduction in the amplitude of evoked responses was ascribed to a compromised action potential invasion of presynaptic terminals possibly due to inactivation of sodium channels resulting from nicotine-induced depolarization. To summarize, prolonged stimulation of presynaptic vesicle release imposes significant influence upon neuron-to-neuron communication, with distinct mechanisms in different brain regions. / Medicine, Faculty of / Graduate

Infusion of a dopamine D1-receptor antagonist into both the dorsolateral and dorsomedial striatum interfered with quinine-resistant alcohol drinking, but not unadulterated alcohol consumption. Dopamine in these two brain regions play a role in compulsive-like alcohol consumption.

Huntington’s disease is an inherited neurodegenerative disease characterized by the degeneration of the cerebral cortex, thalamus, and striatum. The loss of neurons in the cerebral cortex and the thalamus may affect the synaptic circuitry in the striatum as these regions send glutamatergic projections (corticospinal & thalamostriatal) to neurons in the striatum. Prior studies have suggested the detrimental impact that the mutant Huntingtin protein (mHTT) may have on corticostriatal afferents, but less is known thalamic inputs to the dorsal striatum. In this study, we report a 50% reduction in thalamostriatal axospinous synapse density and significant reductions in dendritic spine volume at the ultrastructural level using electron microscopy. Additionally, dystrophic alterations to mitochondria size and morphology were also found. At the microcircuit level, we report a reduction in the spatial abundance of thalamostriatal axon terminals at the rostral, middle, and caudal levels of the dorsolateral striatum while an inverse distribution was observed for mHTT, suggesting a novel topographic distribution of thalamostriatal projections and mHTT along the rostral-caudal axis of the dorsolateral striatum. These findings are novel in the Q175 HD mouse model and supports the theory of an excitatory: inhibitory imbalance contributing to structural synaptic changes in the dorsal striatum. Further studies of the corticostriatal projections will determine the global extent of this imbalance.

The increase in extracellular dopamine (DA) following cocaine administration plays a major role in cocaine abuse. In vitro, cocaine binds to DA transporters (DAT) and blocks DA uptake. Moreover, cocaine can increase extracellular DA concentration as measured by in vivo neurochemical methods. The present study examined the effects of cocaine and other drugs on DA, NE and 5-HT uptake using an ex vivo assay. Rats were injected i.v. with saline or drug and sacrificed at various time points after injections. Brains were dissected for regional monoamine uptake studies ex vivo. In most brain regions, cocaine given in vivo blocked monoamine uptake as expected. [ H]DA uptake in nucleus accumbens was inhibited with an ED = 22.3 μmol/kg. Cocaine fully inhibited [ H]NE uptake (ED = 4.58 μmol/kg) in the occipital cortex and partially inhibited [ H]5-HT uptake (33% at 30 μmol/kg) in the midbrain. However, under the same conditions [ H]DA uptake in the striatum was not inhibited after injections of cocaine up to 56 μmol/kg. Although the mechanism for this discrepancy is unclear, DA binding and uptake sites may be distinct and/or there may be regional differences in DA transporters.

Epidemiological studies implicate pesticide exposure as a possible etiologic factor in idiopathic Parkinson's Disease, which results from degeneration of nigrostriatal neurons, along with reduced levels of the neurotransmitter, dopamine. Behavioral and neurochemical analyses in C57BL6 mice were performed following a subchronic dosing regime with the organochlorine insecticide heptachlor or the pyrethroid deltamethrin. Results were compared to those induced by the established parkinsonian neurotoxicant, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). At the end of the treatment period, mice were assessed for effects on behavior, as well as levels of striatal dopamine, nerve terminal respiration, and synaptosomal dopamine transport. The primary behavioral effect of deltamethrin was incoordination, while heptachlor caused hyperexcitability and increased locomotion. The major neurochemical effect observed for both compounds was upregulation of the presynaptic dopamine transporter (DAT) by 70% and 100% for deltamethrin and heptachlor, respectively. The insecticides exerted only modest effects on striatal levels of dopamine and its metabolite, dihydroxyphenylacetic acid. However, doses of heptachlor higher than those which caused induction of DAT (e.g. greater than or equal to 25 mg/kg), when administered subchronically, were found to cause convulsions in some animals and caused marked, dose-dependent depression of basal striatal tissue respiration rates. No synergism was observed between the effects of insecticides and MPTP. Enhanced transport was thought to be a compensatory effect from increased release of transmitters by the insecticides, <i>in vivo</i>. Striatal dopamine, GABA and glutamate nerve terminals were differentially sensitive to the releasing effects of heptachlor compared to cortical serotonin terminals, and responded in the following rank order of sensitivity: dopamine > GABA > glutamate > serotonin. Additional experiments to characterize the mechanism(s) by which cyclodienes facilitate release of neurotransmitters in synaptosomes demonstrated a lack of distinct Ca²⁺ component and no involvement of retrograde DAT activity, suggesting that released label was of vesicular origin, but did not require Ca²⁺. Insecticidal toxicants, such as organochlorines and pyrethroids, which augment dopamine release and increase the maximal rate of dopamine uptake, may inundate the cytosol of nigrostriatal neurons with high concentrations of free dopamine, which has been shown by other researchers to induce apoptosis and may thereby contribute to the development of Parkinson's disease. Funding for this work was provided under grant number HHHREP 94-01 by the Hawaii Heptachlor Foundation, a non-profit organization. The Hawaii Heptachlor Foundation may be contacted at the following address: Ocean View Center PH#3, 707 Richards St., Honolulu, HI 96813. / Ph. D.

Le système des noyaux de la base est principalement impliqué dans le contrôle et l'apprentissage moteur.Le rôle de la voie cortico-striatale a été et est toujours fortement étudié mais le striatum reçoit aussides afférences excitatrices du thalamus, souvent considéré comme un simple relais entre les noyaux dela base et le cortex, formant ainsi des boucles de structures sous-corticales. Les principales afférencesthalamostriatales glutamatergiques proviennent des noyaux thalamiques intralaminaires et forment descontacts synaptiques avec les deux types de neurones efférents GABAergiques du striatum (i- et d-MSNs) et les interneurones cholinergiques (INCs). Le complexe thalamique intralaminaire peut sedistinguer en une partie rostrale (ILTr) contenant les noyaux centrolatéral (CL), paracentral (PC) etcentral médial (CeM) et une partie caudale (ILTc) formée du noyau parafasciculaire (Pf) chez lerongeur (équivalent du complexe parafasciculaire-centromedian chez le primate). Le complexe thalamiqueintralaminaire est souvent considéré comme une structure fonctionnelle homogène, cependant de plus enplus d’études mettent en évidence des différences anatomiques, électrophysiologiques et fonctionnelles desparties rostrales et caudales de l’intralaminaire. Le noyau intralaminaire caudal est de mieux en mieuxdécrit et sa projection striatale se montre impliquée principalement dans la réponse aux stimuli sensorielsainsi que dans la flexibilité motrice. Des données obtenues par Marco Diana et collaborateurs à l’EcoleNationale Supérieure (Paris) apportent un éclairage nouveau sur l'importance du noyau intralaminairerostral, en particulier le noyau centrolatéral, dans le contrôle du mouvement, en montrant que la stimulationoptogénétique de la projection glycinergique/GABAergique ponto-intralaminaire thalamique inhibe les neu-rones thalamiques et provoque une hypolocomotion. Ces résultats indiquent que la suppression de laprojection thalamique sur le striatum mène à une perturbation de la fonction des ganglions de la base.Cette dernière décennie se caractérise par une explosion de nouvelles techniques aussi bien dans lesdomaines d’imagerie que dans les techniques de manipulation génique d’animaux permettant de répondreà certaines questions qui ne pouvaient techniquement pas trouver de réponse jusqu’ici. Ce travail dethèse a pour but de mieux comprendre l’importance des afférences du thalamus intralaminaire sur lestriatum, en particulier sa partie rostrale, qui, de manière surprenante, sont très mal caractérisées. Deplus, les noyaux thalamiques intralaminaires sont un relais entre le cervelet et le striatum, par conséquent,l'analyse de ces connexions pourrait améliorer notre compréhension des maladies neurodégénératives tellesque la maladie de Parkinson impliquant à la fois les noyaux gris centraux et le cervelet, mais dont lesinteractions fonctionnelles n'ont pas encore été décryptées.La première partie de ce travail de thèse consiste en une étude anatomique détaillée des projections duthalamus intralaminaire sur le striatum, en particulier sur ses principales sous-populations (d- et i-MSNs,INCs) et sous-régions (dorso-latéral=DLS, dorso-médian=DMS), par l’utilisation combinée d’un marquagerétrograde monosynaptique et d’une technique de transparisation (« clearing ») permettant par la suitede réaliser une imagerie complète du cerveau à l’aide d’un microscope à feuille de lumière. Les analysesanatomiques réalisées ont permis de confirmer l’existence de projections directes des noyaux thalamiquesintralaminaires sur le striatum dorsal, celles-ci présentant un pattern d’innervation préférentiel pour lesINCs (DMS>DLS) suivi par les dMSNs (DLS>DMS). Les cibles postsynaptiques des projectionsthalamostriatales sont similaires aux projections dopaminergiques, suggérant une interaction étroite entreces afférences.La seconde partie de cette thèse, vise a mieux comprendre l’importance fonctionnelle des connexionsthalamostriatales mises en évidence précédemment dans la locomotion spontanée. Pour cela deux ap-proches seront utilisées: une approche modifiant l’activité de ces neurones par l’utilisation de techniquescomme l’optogénétique et la chémogénétique et une approche descriptive par une technique d’imageriecalcique permettant d’enregistrer l’activité neuronale en temps réel sur des animaux libres de se mouvoir.Les résultats obtenus montrent que l’inhibition de l’ensemble des neurones de l’ILTr est nécessaire pourobserver un phénotype moteur d’hypolocomotion. La mise en place d’un système de détection de motricitéfine et l’enregistrement de l’activité calcique des neurones striataux, nous permettront, à l’avenir, de mieux identifier le type de comportement moteur impliqué dans cette hypolocomotion ainsi que d’évaluer l’impactde cette inhibition thalamique sur l’activité des neurones striataux. / Doctorat en Sciences biomédicales et pharmaceutiques (Médecine) / info:eu-repo/semantics/nonPublished

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20262号 / 医博第4221号 / 新制||医||1020(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 伊佐 正, 教授 松原 和夫, 教授 村井 俊哉 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM