Biomedical subjects
Publications and source records attributed to H Shoji.
Familial cases of HTLV-I-associated myelopathy (HAM) and adult T-cell leukemia (ATL), developing in a daughter and father, respectively, are reported. The coexistence of both diseases in a family has not been reported before. This supports the recent findings that ATL and HAM may be brought about by an identical virus on an apparently different immunogenetic background.
N-[(1-butyl-2-pyrrolidinyl)methyl]-2-methyl-5-sulfamoyl-2,3- dihydrobenzofuran-7-carboxamide hydrochloride (Y-20024) was synthesized in our laboratories in anticipation of developing a new psychotropic drug. In the present study, the pharmacological properties of Y-20024 were compared with those of sulpiride (SPR) and haloperidol (HPD). Administered orally, Y-20024 was 10 times stronger than SPR in inhibiting apomorphine (0.5 mg/kg, s.c.)-induced hyperactivity in mice; administered intravenously or intracerebroventricularly, it was 2 times or one third as strong, respectively. Y-20024 was almost equipotent to SPR in antagonizing apomorphine (0.1 mg/kg, s.c.)-induced vomiting in dogs. Combined with methamphetamine (5 mg/kg, i.p.), Y-20024 and SPR induced mortality dose-dependently in rats, but HPD did not. The mammotropic activity of Y-20024 administered orally once a day for 5 days was almost equipotent to that of SPR. From these results, Y-20024, pharmacologically similar to SPR, but superior in bioavailability and penetration through the blood brain barrier, may have potential usefulness as an antipsychotic drug.
A case involving a 34-year-old female with a progressive hemiparesis is described. She had a history of repeated spontaneous abortions. The CT and magnetic resonance imaging (MRI) showed a multiple cerebral infarction. A 99mTc perfusion lung scintigram demonstrated diffuse bilateral perfusion defects in the lungs. The presence of lupus anticoagulant (LA) was detected from the laboratory data and the thrombosis in the genital organ. The repeated abortions were probably due to thrombosis in the placental vessels caused by LA. High dose steroid therapy was effective in suppressing the LA activity and in preventing progression of the clinical symptoms.
We analyzed various biochemical variables of the bones in fetal rats whose dams were protein-energy malnourished. Dams were randomly divided into two groups and fed either a 6% protein diet as a malnourished group or a 20% protein diet as a control, from day 13 of gestation to day 22, when fetuses were removed. Hexosamine and hydroxyproline contents of the calvaria and hexosamine contents of long bones were greater in the malnourished group than in the controls. Sequential extractability of collagen differed among various bones in the malnourished group and controls. The ratio of alpha:beta obtained from SDS-polyacrylamide gel of neutral salt-soluble collagen tended to increase in the long bones and mandible, and decrease in the calvaria and ribs in the malnourished group. Also, the ratio of alpha 1:alpha 2 tended to be lower in the malnourished group than in the control group in all bones. Protein-energy malnutrition during pregnancy has shown to affect biochemical composition of various fetal bones.
The RGO Generation II reciprocating gait orthosis was jointly developed by Louisiana State University Medical Center and Durr-Fillauer Medical, Inc, to overcome four problems encountered with the existing model: 1) The high energy cost of locomotion; 2) the great arm strength required for patients to stand up from the seated position without assistance; 3) difficulty (especially for patients with hamstring contracture) in remaining standing owing to failure of the knee latch to lock except in full extension; and 4) problems in balancing when ambulating on an incline. The RGO Generation II employs concurrent electrostimulation of the rectus femoris and hamstrings to assist in rising and balancing and a ratchet-type latching device to improve safety and stability in standing. Alternating stimulation of the rectus femoris and contralateral hamstrings are used for locomotion. Testing in six patients with thoracic paraplegia demonstrated an average 30+% reduction in energy expenditure at a walking speed of .05 m/s and a 15+% reduction at .37 m/s; improved mobility and better balance on inclines; and unassisted rising in all patients. Walking range was increased from an average of 100 m to an average of 800 m. More research is needed to provide stair-climbing ability and to further reduce energy expenditure.
Two cases of Vogt-Koyanagi-Harada disease with rare neurological complications were reported, which are one case with vestibular and cerebellar ataxia, and one with multiple cranial nerve palsies. The first case, a 32-year-old man, was admitted to our ophthalmologic department because of visual impairment. Two weeks later, he complained of gait disturbance. Limb and truncal ataxia, vestibular dysfunction and perceptive deafness were observed. Ophthalmologic examination revealed typical findings of Vogt-Koyanagi-Harada disease. CSF showed elevated protein and mononuclear pleocytosis. After treatment with oral steroid therapy, vestibular and cerebellar ataxia, and visual impairment improved. The second case, a 22-years-old man, showed the VIIth, VIIIth, IXth, and Xth cranial nerve palsies with visual impairment, and he was diagnosed to have cranial nerve palsies associated with Vogt-Koyanagi-Harada disease. After steroid therapy, there was a marked clinical improvement. Vogt-Koyanagi-Harada disease is an autoimmune disease against the melanocytes and involving tissues containing melanocytes such as uvea, meningea, skin and inner ear, etc.. Neurological complications except for meningitis and perceptive deafness have been rarely reported in Japan. Related to the present cases, possible pathogenesis was discussed.
Thirty-five patients who had rheumatoid arthritis of both knees, but no gross deformity of the patella, had bilateral total knee arthroplasty. In each patient, one knee had a patellar replacement and the other did not. All of the patients were followed for a minimum of two years. The results were the same in both knees in terms of relief of pain and improvement in function, arc of motion, and muscle power. Although no complications that were related to patellar replacement developed in these patients, routine replacement of patellae that have little or no deformity does not seem advisable.
A case of multiple sclerosis (MS) in a 39 year old Japanese female with high antibody titer to human T-lymphotropic virus type I (HTLV-I) in serum and cerebrospinal fluid (CSF) was reported. At the age of 15, gait and urinary disturbances accompanied by sensory impairment in the lower abdomen and lower extremities developed suddenly. The motor disturbance slowly progressed to tetraparesis over a period of 15 years with several remissions. At the age of 28 the patient suffered from an acute loss of visual acuity, unilateral initially, and became blind by the age of 34. On admission to our department in September, 1987, the patient was alert and had spastic paraparesis, the impairment of all sensory modalities below the level of Th 10 and urinary disturbance. Weakness of facial muscles, nystagmus, deviation of the tongue and dysarthria were also noted. By the PA method, the antibody titer to HTLV-I was measured x512 in the serum and x64 in the CSF. Western blotting analysis of the CSF disclosed the bands to p19, p24 and p28 of HTLV-I gag proteins. The CSF contained a few ATL-like atypical cells and showed mild lymphocytosis, but the total protein was not increased. The computed tomography revealed diffuse low density areas in the cerebral white matter. The magnetic resonance imaging disclosed high intensity signal areas in the cerebral white matter and in the dorsolateral portion of the medulla oblongata on the T2 weighted image. The link of HTLV-I infection to the pathogenesis of human demyelinating diseases was discussed.
One hundred complex femur fractures were treated with the Grosse-Kempf interlocking nail and 35 were treated with the Wagner external fixation device. Retrospectively, we analyzed the results in the two groups to determine specific indications for the future use of these nails. The Grosse-Kempf nail, although a technically demanding procedure, achieved excellent overall end results in comminuted closed fractures, and in Type I, Type II, and some Type III open fractures after appropriate wound care. We found that the Wagner apparatus was a simple, easy device for obtaining initial fracture stabilization in contaminated Type III-B and Type III-C open fractures. It does, however, require substantial postoperative care; four cases required secondary intramedullary fixation. We found a high infection rate with secondary reamed intramedullary nailing after initial stabilization with the external fixator.
The effects of prenatal protein-energy malnutrition on the biochemical parameters of the membranous bone were studied using fetal rats. Timed pregnant rats were fed a protein-deficient diet as an experimental group from day 13 of gestation, whereas control dams were fed a normal protein diet. By day 15, radioactive Na2SO4 was injected. On day 22, all fetuses were delivered by cesarean section. The hexosamine content per milligram dry tissue, and the protein and hexosamine contents per guanidine-HCl extract were greater in the mandibles but less in the calvaria of the malnourished group than in those of the controls. Calcium content per gram dry tissue was lower in both bones of the malnourished group. 35S-sulfate uptake per milligram dry tissue or milligram proteoglycan was greater in the malnourished group than in the controls in both bones. The mandible in the malnourished group had less lower-weight molecular proteoglycan subunits in the dissociative condition. Protein-energy malnutrition affects the mandible and calvaria in different ways, although both bones originate from membranous bone. Insufficient degradation of proteoglycan could be the reason for the delay of mineralization in the malnourished bones.
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We studied the biochemical effects of excess methionine intake on the skin of newborn rats. Group 1 pups were intubated with methionine dissolved in 0.1 ml physiological saline solution in the amount of 0.1 g/100 body wt as a control using a gastric needle. Group 2 pups were given 0.2 g/100 g in the same manner as group 1 as an experimental group. They were intubated every other day from day 3 to 13. On Day 15, [14C]proline was injected intraperitoneally into pups and their skin was removed. 14C total and hydroxyproline uptake was examined in the tissue as well as in the sequential extracts. Although excess methionine intake by the pups did not alter the collagen content of their skin, it caused an increase in the content of type III collagen and a decrease in crosslinked collagen. In addition, newly synthesized collagen in the neutral salt extract increased in the excess methionine group, indicating that crosslinked collagen decreases as excess methionine was intubated. The present study demonstrated that excess methionine in the early lactational period altered the nature of the skin collagen of suckling newborn rat pups.
1. Various biochemical variables of the skins of rat dams and their fetuses in which protein-energy malnutrition was induced during pregnancy were analysed. 2. One group of dams was fed on a 200 g protein/kg diet as a control and the other was fed on a 60 g protein/kg diet as an experimental group. Each group of dams was fed from day 13 of gestation until day 22. 3. Water, protein and hexosamine concentrations of the fetal skins in the malnourished group were greater than those in the control group, whereas in the dams' skins, protein concentration was greater in the malnourished group than in the control group. 4. Extractability of collagen with neutral salt and pepsin showed no difference between the groups in the skins of fetuses and dams. The content of type III collagen in the fetal skin did not differ between the groups, but was increased in the malnourished dams' skins compared with that of the control group. 5. The present study showed that protein-energy malnutrition during pregnancy significantly affects the metabolism of the skin in both fetuses and their dams. Furthermore, the skins of fetuses and dams are structurally altered in different ways by this nutritional stress.
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