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Biomedical subjects

E Uyama

Publications and source records attributed to E Uyama.

At least 73 records · Page 4Linked to original sources

Dystrophin and dystrophin-related protein in the brains of normal and mdx mice.

To clarify the localization and characterization of dystrophin and dystrophin-related protein (DRP) in the brains of normal and mdx mice, we carried out immunostaining and immunoblotting studies using four region-specific antidystrophin and anti-DRP antibodies. With immunostaining, punctate immunoreactivity of dystrophin was seen along the cell bodies and dendrites of the cerebral cortical neurons in the normal mice. By contrast, dystrophin was not detected at all in the brains of mdx mice. Immunoreactivity of DRP was observed in the vascular walls, pia mater, and choroid plexus of both normal and mdx brains, but not in the neuronal cells. The possible compensatory increase of DRP as seen in the skeletal muscles of mdx mice was not noted in the brains. The immunoblot findings were very consistent with those of immunostain. Although further studies of brain-type dystrophin are necessary, it seems unlikely that DRP participates in any physiological function of the neuronal cells.

Animals↗

Cognitive event-related potentials and brain magnetic resonance imaging in HTLV-1 associated myelopathy (HAM).

Auditory and visual cognitive event-related potentials (ERPs) were investigated in 14 patients with HTLV-1 associated myelopathy (HAM) and in 36 normal controls. In the HAM patients, the latencies of P300 and N200 by the auditory tone method were significantly delayed, and N100 by the auditory click method was significantly delayed in latency. No abnormal ERP components were observed with visual methods. While these auditory abnormal ERPs were present in the HAM patients, there was no evidence of visual abnormal ERPs. Abnormal lesions on the white matter were evident at magnetic resonance imaging (MRI) in 6 (75%) of 8 patients. There was no correlation between MRI lesions and the abnormalities of ERPs, but there was a significant correlation between bifrontal index on MRI and P300 amplitudes at Cz and Pz sites by auditory tone method. In one patient, atrophy of bilateral parietal lobes was seen on MRI and P300 latencies delayed using various methods. Therefore, the possibility that electrophysiological cognitive impairment in patients with HAM is related to brain atrophy rather than to white matter lesions requires attention.

Adult↗

PCR and immunoblot analyses of dystrophin in Becker muscular dystrophy.

The dystrophin gene was examined by PCR analysis in 30 Japanese patients with Becker muscular dystrophy (BMD). Fifteen PCR of these patients had exon deletion, generally, less than three exons. Muscle biopsies were also performed in 20 BMD patients (10 with sequence deletions, and 10 without detectable sequence deletions) in order to correlate PCR findings with immunoblot and immunostaining data. A patchy, heterogeneous membrane immunostaining pattern of reduced intensity was found, irrespective of the presence or absence of deletions. Immunoblotting studies demonstrated dystrophin of low molecular mass and quantity in BMD patients with deletion mutations, while a low quantity of dystrophin with an apparent wild type molecular mass was observed in nearly half the BMD patients without detectable deletions. However, these dystrophins were also found to have slightly abnormal molecular masses when the standard electrophoresis time was prolonged. This suggests that immunoblots and PCR data correlate well in patients with BMD. Additionally, it is suggested that immunoblot assays can detect abnormalities in dystrophin in the absence of detectable PCR deletions.

Adolescent↗

Adult Chédiak-Higashi syndrome presenting as parkinsonism and dementia.

Chédiak-Higashi syndrome (CHS) in children can be a fatal disease. We describe the oldest known CHS patient first seen with a neurologic disorder in early adult life. From the age of 22, this 39-year-old woman developed mental deterioration, parkinsonism including resting tremor at the tongue, mandible, and hands, oculogyric crisis, muscular atrophy of limbs, and loss of tendon reflexes. MRI showed marked temporal dominant brain atrophy and diffuse spinal cord atrophy. Partial albinism, pan-leukocytic giant granules, and profoundly decreased NK-cell activity were compatible with childhood CHS, but apparently normal neutrophil function prolonged her survival. Stimulated proliferation of lymphocytes was less than 40% that of normal controls.

Adult↗

Abnormal excretion of urinary phospholipids and sulfatide in patients with mitochondrial encephalomyopathies.

We found that patients with mitochondrial encephalomyopathies excreted urinary phosphatidylethanolamine, cardiolipin, and phosphatidylserine most likely derived from mitochondria and sulfatide which is specific to myelin or the kidney. It is of interest that four patients with myoclonus epilepsy with ragged-red fibers and one patient with chronic progressive external ophthalmoplegia all showed qualitatively similar abnormal excretion of such urinary lipids. It is conceivable that the urinary acidic phospholipids reflect abnormalities in the mitochondrial phospholipids, which are very important for mitochondrial enzymatic activities.

Adolescent↗

A histochemical and electron microscopic study of skeletal muscle in an adult case of Chédiak-Higashi syndrome.

To clarify the muscle pathology findings of a 39-year-old female Chédiak-Higashi syndrome (CHS) case with diffuse limb muscle atrophy, histochemical and electron microscopic studies were performed. In addition to neurogenic muscle atrophy due to the peripheral neuropathy, the most striking change seen by light microscopy was the widespread appearance of acid phosphatase-positive granules in many normal-looking muscle fibers. Coincident with the histochemical findings, electron microscopy showed many autophagic vacuoles containing glycogen particles and membranous structures in almost all muscle fibers. Although further studies are necessary, diffuse distribution of acid phosphatase-positive granules (autophagic vacuoles) in the skeletal muscle may reflect one of the generalized lysosomal abnormalities in CHS.

Adult↗

Presenile-onset cerebral adrenoleukodystrophy presenting as Balint's syndrome and dementia.

We describe a patient with presenile-onset cerebral adrenoleukodystrophy presenting as Balint's syndrome and dementia. There were demyelinating MRI changes in the parieto-occipital white matter bilaterally, including the splenium of the corpus callosum. Therapeutic trials using 1-deamino-(8-D-arginine)-vasopressin, very long-chain fatty acid-free diet, and gamma-globulin were of no benefit.

Adrenoleukodystrophy↗

Increased human T lymphotropic virus type-1 (HTLV-1) proviral DNA in peripheral blood mononuclear cells and bronchoalveolar lavage cells from Japanese patients with HTLV-1-associated myelopathy.

Human T lymphotropic virus type-1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is endemic in tropical areas and in southwestern Japan, and has now been identified among risk groups in the United States and some European countries. Patients with HAM/TSP may also have T lymphocyte alveolitis related to the HTLV-1 infection. To quantify proportions of HTLV-1-infected cells, a fragment of HTLV-1 proviral DNA was amplified from peripheral blood mononuclear cells (PBMC) and bronchoalveolar lavage (BAL) cells obtained from patients with HAM/TSP, non-HAM/TSP HTLV-1 carriers with chronic pulmonary inflammation, and asymptomatic HTLV-1 carriers. The proportion of HTLV-1-infected cells in PBMC from patients with HAM/TSP was much higher (3-30%) than that from asymptomatic HTLV-1 carriers (mostly < 1%), based on findings with the quantitative polymerase chain reaction. In non-HAM/TSP carriers with chronic pulmonary inflammation, HTLV-1-infected cells in PBMC were also increased, but not as markedly as that seen in patients with HAM/TSP. Integration of HTLV-1 was also noted in BAL cells from patients with HAM/TSP or non-HAM/TSP carriers with chronic pulmonary inflammation. However, in patients with HAM/TSP, there was a marked increase in HTLV-1-infected cells in the lung (7.5-30% of BAL cells), as compared with findings in non-HAM/TSP carriers (< 5%). These results suggest that increased HTLV-1 proviral DNA loading may play an important role in the development of T lymphocyte alveolitis and myelopathy in patients with HAM/TSP.

Adolescent↗

GM1 gangliosidosis in adults: clinical and molecular analysis of 16 Japanese patients.

Clinical findings were compared with the results of molecular analysis in 16 Japanese patients from 10 unrelated families with the adult/chronic form of GM1 gangliosidosis. Age of onset ranged from 3 to 30 years. Major clinical manifestations were gait and speech disturbances caused by persistent muscle hypertonia. Dystonic postures and movements, facial grimacing, and parkinsonian manifestations were commonly seen. Cerebellar signs, myoclonus, severe intellectual impairment, dysmorphism, or visceromegaly were not observed. A common single-base substitution, 51Ile(ATC)----Thr(ACC), reported in a previous study of ours, was confirmed in 14 patients by the Bsu36I restriction site analysis; one was a compound heterozygote with another mutation (457Arg[CGA]----Gln[CAA]) and the others were homozygotes of this mutation. Clinically, the compound-heterozygous patient showed more severe neurological manifestations and a more rapid clinical course than those of homozygotes. The homozygotes showed considerable variations in the age of onset and subsequent clinical course. The 51Ile----Thr mutant allele expressed a significant amount of beta-galactosidase activity, whereas the 457Arg----Gln mutant allele expressed extremely low activity in human GM1 gangliosidosis fibroblasts. We conclude that these gene mutations causing different residual enzyme activities are related to the severity of clinical manifestations, but some other genetic or environmental factors contribute to clinical heterogeneity. The Bsu36I restriction site analysis was performed in 7 families and provided clear results for the diagnosis of heterozygotes as well as homozygotes of this specific clinical form of GM1 gangliosidosis. The technique is applicable to prenatal diagnosis and genetic counseling.

Adult↗

Hydrocephalus, corneal opacities, deafness, valvular heart disease, deformed toes and leptomeningeal fibrous thickening in adult siblings: a new syndrome associated with beta-glucocerebrosidase deficiency and a mosaic population of storage cells.

We describe three adult siblings with communicating hydrocephalus, corneal opacities, deafness, valvular heart disease, and deformed toes associated with glucosylceramide (glc-cer)-beta-glucosidase deficiency. The common manifestations of Gaucher disease were not evident. Supranuclear gaze palsies characteristic of type 3 were noted from early childhood, although the major signs were undeveloped until early adult life. Autopsy disclosed thickened leptomeninges with perivascular fibrosis, non-rheumatic calcified aortic and mitral stenosis with marked fibrosis, and mild infiltration of Gaucher cells in the reticuloendothelial organs. In contrast to the slight accumulation of glc-cer in the liver and spleen, the activity of glc-cer-beta-glucosidase was markedly decreased in the tissues, as much as in a patient with type 2 Gaucher disease. Common mutations were not found in the glucocerebrosidase gene.

Adult↗

Type 3 GM1 gangliosidosis: characteristic MRI findings correlated with dystonia.

We describe three brothers with type 3 GM1 gangliosidosis presenting as dystonia. The ages of the patients when examined were 28, 31, and 33. They had developed dysarthria with facial grimacing since early childhood. The common neurological sign was generalized dystonia. Both dystonic postures and dystonic movements resulting from varying degrees of fixed rigidity of each muscle involved did not disappear when the patients were lying or sitting relaxed. There was no correlation between the severity of dystonia and the residual activities of acid beta-galactosidase. Magnetic resonance imaging (MRI) showed bilaterally symmetric high intensity lesions only in the putamen on T2-weighted and proton density images. Selective putaminal changes on MRI may be the lesions most responsible for symptomatic dystonia in this disorder.

Adult↗

[A case of HTLV-1 associated myelopathy progressed in course over 30 years].

A 66-year-old female suffering from HTLV-1 associated myelopathy (HAM) for more than 30 years was hospitalized because of memorial impairment, deafness, dysarthria, dysphagia, and complete paraplegia. She first noticed stiffness and weakness of the right leg at 35 years of age. Gait disturbance was slowly progressed and complete paraplegia developed 18 years later. Neurological examinations on admission revealed that she was bedridden with decubitus, mental deterioration (pre-dementia of subcortical type), bilateral optic nerve atrophy, severe sensory-neural deafness, dysarthria, complete paraplegia, and marked neurogenic bladder. Laboratory data showed mild normocytic anemia and moderate diabetes mellitus. Anti-HTLV-1 antibody titers in serum and CSF were 78,192X and 1,024X, respectively (PA method). Serum levels of soluble IL-2 receptor was markedly elevated (2,200 U/ml). Peripheral blood lymphocytes showed spontaneous proliferation when cultured for 5 days (3H-thymidine uptake; 45,285 cpm/5 X 10(4) cells). MRI examinations of the spinal cord disclosed a predominant atrophy of lower thoracic cord without any compressive lesions. Brain MRI showed diffuse high intensity lesions of the periventricular area on T2 weighted images. Such abnormalities were predominantly found in fronto-parietal region and were quite similar to those of leuko-ariosis. Single photon emission CT using 123I-iodoamphetamine showed hypoperfusion of cerebral white matter on delayed image. It has been reported that intellectual impairment and brain atrophy are not usually seen in HAM patients. The present case, however, shows that such abnormalities of the central nervous system could occur in HAM patients with a long duration of illness.

Aged↗

[An adult case of Chédiak-Higashi syndrome with parkinsonism and marked atrophy of the central nervous system].

Chédiak-Higashi syndrome (CHS) is often a fatal disease of childhood characterized by oculocutaneous forms of albinism with congenital gigantism of peroxidase granules, granulation anomaly of leukocytes, hereditary gigantism of cytoplasmic organelles and a marked susceptibility to infections. A few patients have survived to age 20 years. A 39-year-old woman developed tremor and gait disturbance at age 22 years. At age 25 years, she was admitted to the Hospital for evaluation. Mental impairment, horizontal nystagmus, bradyphrenia, cogwheel rigidity, tremor at tongue, mandible and hands, bradykinesia, and unsteady gait were found and a juvenile parkinsonism was diagnosed. However, there was no favorable response by levodopa therapy. She became unable to walk at age 33 years. On admission, Oct. 27, 1988, at age 39 years, she was bedridden with a posture of decorticate rigidity. She was found to have partial depigmentation of the retina and choroid, pale and atrophic optic disc and subluxation of the mandible, Onuaguluchi's finger deformities and pes cavus. Neurological examination disclosed that she was alert but had marked difficulty in speaking. The communication was only possible by giving a sign of grasping of the left hand. The patient also showed oculogyric crisis, dystonic rigidity of the neck, diffuse muscular atrophy, complete paraplegia and decreased deep tendon reflexes with Babinski sign. On laboratory studies, at age 39, the white cells count was decreased (2,510/mm3), the hemoglobin level was 10.3 g/dl, the serum iron was 12 micrograms/dl, IgG 2,828 mg/dl, IgA 1,002 mg/dl, and the activity of natural killer cell was profoundly decreased (2%, normal; 18-40). Hematological examination revealed peroxidase positive giant granules in leukocytes. Chest X-ray film disclosed marked abnormal colon gas which located right subdiaphragma (Chilaiditi syndrome). Cerebrospinal fluid contained 12 cells/mm3, 99% lymphocytes; protein, 58.8 mg/dl; IgG, 6.8 mg/dl; HVA, 4.5 ng/ml (normal 41.8-44.6); 5-HIAA, 1.3 ng/ml (11.3-29.2); MHPG, 5.8 ng/ml (13.2-22.2).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Spontaneous T cell proliferation and release of soluble interleukin-2 receptors in patients with HTLV-I-associated myelopathy.

Patients with human T lymphotropic virus type I (HTLV-I)-associated myelopathy (HAM) show increased serum levels of soluble interleukin-2 receptors (sIL-2R), a marker of T cell activation. We found that peripheral blood lymphocytes from HAM patients proliferated spontaneously and released sIL-2R when cultured in vitro. Spontaneous proliferation was observed in T cell populations (both CD4+ cells and CD8+ cells), but not in B cell-rich populations or monocyte-rich populations. There was a significant increase of IL-2 activity in the culture supernatants of peripheral blood mononuclear cells (PBMC) after 2-3 days cultivation. On the other hand, sIL-2R concentrations in the supernatants were much higher after 5 days of cultivation. Such spontaneous T lymphocytic proliferation and release of sIL-2R were also found in non-HAM HTLV-I carriers, but not as intensely as in HAM patients. HTLV-I infection causes T cell activation to release IL-2 and sIL-2R; such T cell responses may play a role in the pathogenesis of HTLV-I-associated myelopathy.

Adult↗

[Three siblings with type 3 GM1-gangliosidosis--pathophysiology of dystonia and MRI findings].

GM1-gangliosidosis is a rare neurovisceral storage disease caused by an inherited deficiency of acid beta-galactosidase. The characteristic neurological feature of type 3 (adult or chronic) GM1-gangliosidosis is usually a slowly progressive dystonia with dysarthria due to predominant involvement of basal ganglia. About 20 adult patients with this disorder have been reported in the literature. However, there are no reports of 3 brothers with type 3 GM1-gangliosidosis, and MRI findings. Case 1 (proband): A 28-year-old man was hospitalized because of facial grimace, dysarthria, and generalized dystonia. He was born after normal pregnancy and delivery. His development was normal until 3 years of age when the difficulties of speaking and walking were noticed by his parents. These neurological abnormalities progressed slowly and facial grimace and dystonic movements occurred 7 years later. He could not walk at 22 years of age. On admission, he was bedridden with marked scoliosis and subluxation of the mandibule. The communication was possible only by pointing the words written on the board. Case 2: A 33-year-old man, elder brother of case 1, showed the similar neurological features and clinical course. Slit-lamp examination revealed corneal opacities which were located in the deep stroma. Case 3: A 33-year-old man, elder brother of case 1 or case 2. At age 10-11, he noted similar symptoms as case 1 or case 2. The severity of dystonia was milder than his brothers. A diagnosis of GM1-gangliosidosis in three patients was made on the basis of the following data.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Oculopharyngeal muscular dystrophy in a Japanese family].

The first instance of familial oculopharyngeal muscular dystrophy (OPMD) affecting a Japanese family is reported. Three patients (a 62-year-old female, her sisters 66-year-old and 53-year-old) were described with suspicious other 2 cases. A 62-year-old woman (case 1) developed bilateral blepharoptosis at the age of 52. Then she became aware of difficulty in swallowing solid foods, had developed a nasal voice and aspiration of liquids. On admission, neurological examination revealed moderate bilateral blepharoptosis, nasal voice, dysphagia and hyporeflexia of the pharynx. There was mild weakness of the muscles of the temporalis, masseter, face, neck and proximal portions of the upper limbs. The levels of serum creatine phosphokinase, lactic acid and pyruvic acid were normal. Tensilon test was negative. The needle EMG showed a myogenic pattern with no waning phenomenon. Nasopharyngeal fiberscopy, laryngoscopy, esophageal fluoroscopy and hydrodynamic examination showed dyskinesis of the soft palate, retention of saliva in recessus piriformis and streaming into the larynx. Cricopharyngeal myotomy was performed for the purpose of relieving the dysphagia. The muscles were obtained from cricopharyngeus of both sides during surgery, and right deltoid muscle in biopsy. The muscles of sternohyoideus and deltoideus showed myogenic changes, and some fibers with rimmed vacuoles especially in small angulated fibers under the light microscope. Whereas the crycopharyngeus showed dystrophic change, which was apparent in the right side. There were also nemaline rods found in a few fibers undergoing necrosis. ATPase preparations revealed type 1 predominant in cricopharyngeus and type 2 predominant in sternohyoideus. Most atrophic fibers were in type 1 fibers.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Progressing ischemic stroke in a homozygote with variant antithrombin III.

A 31-year-old woman developed disturbance of consciousness and left hemiparesis. Cerebral computed tomograms showed a low-density area in the right temporal lobe that extended to the right parietal and left frontal lobes as her clinical symptoms worsened. The diagnosis of familial variant of antithrombin III (AT-III) was based on decreased biologic activity and a normal immunologic level of AT-III in this patient and in her family members. Transfusion of normal AT-III concentrate led to a striking clinical recovery. Blood coagulation studies revealed that nine of 13 family members had decreased biologic AT-III activity and that the patient herself was the only homozygote with variant AT-III. We conclude that variant AT-III, especially in a homozygote, seems to be one cause of ischemic stroke in young adults and that simultaneous measurement of both the biologic and immunologic activities of AT-III is necessary to detect it.

Adult↗