[Three cases of anti-phospholipid antibody syndrome due to SLE].
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Adult↗
Biomedical subjects
H Takami
Publications and source records attributed to H Takami.
Ultrastructure of matriceal changes in chronic phase of Masugi nephritis by quick-freezing and deep-etching method.
The three-dimensional ultrastructure of glomerular sclerosis in the chronic phase of Masugi nephritis was investigated using a quick-freezing and deep-etching method. Newly formed mesangial matrix, which was increased in the axial portions, was composed of fine fibrillar networks similar to those in the lamina densa of the basement membrane. These fibrils were 10-20 nm in diameter and directly attached to the cell membranes of mesangial cells, endothelial cells and podocytes by connecting fibrils. Moreover, thicker fibrils with diameters of 20-30 nm were present in the networks and were connected with cross-bridges. A newly formed matrix of fine fibrillar networks was also seen in the areas of mesangial interposition in the glomerular capillary wall. The border between the matrix and lamina densa was unclear. The fibrils organizing the networks of lamina densa of the glomerular loop were thickened, with some decoration. Connecting fibrils were disrupted in the areas of endothelial detachment. It is suggested that prolonged tissue injury with endothelial detachment might induce mesangial sclerosis composed of fine fibrillar networks. The increase in density of the networks seemingly interfere with the contractile function of mesangial cells, which is followed by alteration of mesangial flow.
Animals↗
Three-dimensional ultrastructure of glomerular injury in serum sickness nephritis using the quick-freezing and deep-etching method.
The three-dimensional ultrastructure of the glomerulus in serum sickness nephritis has been investigated by the quick-freezing and deep-etching method. Compact granular immune deposits were localized in filamentous networks in the lamina densa and mesangial matrices. These constitutional fibrils with diameters of 8-15 nm, were directly attached to the immune deposits. The filamentous networks became markedly loosened around the deposits. In podocytes, reticular microfilaments with positive decoration by myosin subfragment 1 (S1) were increased in flattened foot processes and directly attached to the cell membranes. Fine filaments with diameters of 4-7 nm were undecorated by S1 and connected with actin filaments as cross-bridges. Intermediate filaments were also increased in the cell bodies and primary processes of podocytes. Connecting fibrils in lamina rara externa were partially disrupted. The immune deposits were primarily detected in the networks of lamina densa and actually destroyed the size barrier composed of filamentous networks. Moreover, the mesangial deposits also disorganized mesangial networks to probably alter mesangial flow through the matrices. Increased actin filaments in foot processes seemingly reinforced the cell membranes and the connecting fibrils in lamina rara externa, which prevented the initial detachment of podocytes from the basement membrane.
Animals↗
Post-traumatic rupture of the extensor digitorum communis tendon.
A case of post-traumatic rupture of the common extensor tendon without associated fracture is reported. The extensor digitorum communis tendon to the middle finger was frayed by the distal edge of the extensor retinaculum at the fourth dorsal compartment.
Accidental Falls↗
Rupture of the extensor digitorum communis tendons caused by occupational overuse.
Spontaneous rupture of the extensor pollicis longus tendon in excessive exertion is well-recognised, but similar rupture is rare in the common extensor tendons of the fingers. Two cases caused by occupational overuse are reported. Mechanical attrition at the distal edge of the extensor retinaculum produced by excessive use was thought to be responsible for the rupture.
Adult↗
Ultrastructure of glomerular basement membrane by quick-freeze and deep-etch methods.
The glomerular basement membrane of rat kidneys were three-dimensionally observed by quick-freeze and deep-etch replica methods at high resolution. The middle layer (lamina densa) was composed of 6 to 10 nm fibrils which formed a meshwork structure. The space between the fibrils had polygonal shape. The average long dimension of the space between fibrils was 17 nm and the short one was 13 nm. At the outer layer (lamina rara externa), fibrils connected podocytes perpendicularly with the meshwork of the middle layer. At the inner layer (lamina rara interna), similar perpendicular fibrils also connected endothelial cells with the meshwork of the middle layer. This is the first report to visualize the three-dimensional meshwork structure of the middle layer (the lamina densa) in situ. The function of anchoring podocytes to the lamina densa was suggested in the perpendicularly arranged fibrils of the outer layer. The quick-freeze and deep-etch method is useful in analyzing filamentous ultrastructure in glomeruli, and will be applied to clarifying pathological ultrastructure in kidney diseases.
Animals↗
Rupture of the flexor tendon secondary to osteoarthritis of the pisotriquetral joint: case report.
Attrition ruptures of the flexor tendons in the carpal tunnel are uncommon. A case of rupture of the flexor digitorum profundus tendon to the little finger secondary to osteoarthritis of the pisotriquetral joint is reported. Mechanical attrition against the radial side of the pisiform was thought to be responsible for the rupture.
Cumulative Trauma Disorders↗
Blue rubber bleb nevus syndrome with disseminated intravascular coagulation and thrombocytopenia: successful treatment with high-dose intravenous gammaglobulin.
A 63-year-old woman was diagnosed as having blue rubber bleb nevus syndrome (BRBNS) with disseminated intravascular coagulation (DIC). Hematological data showed typical DIC: PT 13.2 sec, activated PTT 55.3 sec, fibrinogen 20 mg/100 ml, FDP-E 928 ng/ml, D-dimer 3,477 ng/ml, platelet count 25 x 10(3)/microliters. Although hypofibrinogenemia was successfully controlled by the continuous infusion of heparin, 10,000 units/day, thrombocytopenia has continued. Based on shortened platelet life span, high level of platelet associated IgG, and increased number of megakaryocyte in the bone marrow, the thrombocytopenia was thought to be due to antiplatelet antibody. Her platelet count returned to normal after intravenous infusion of high-dose gamma globulin (IVIg, Sandoz) at the dose of 400 mg/kg for 2-5 days, while corticosteroid, Gabexate mesilate, synthetic thrombin inhibitor MD-805, urinastatin and warfarin had no effect. Thus, DIC or thrombocytopenia may become a serious complication in some patients with BRBNS and IVIg may be useful for correcting thrombocytopenia in the patient.
Disseminated Intravascular Coagulation↗
Graves' disease with severe iodine allergy: successful surgery after lithium carbonate treatment. Case report.
A patient with Graves' disease could not receive conventional antithyroid drugs or beta blocking agents because of severe allergy to these drugs and to iodine. Surgery was performed when the thyroid function had been normalized with lithium carbonate. The postoperative course was uneventful.
Aged↗
Hepatic venous oxygen saturation monitoring in patients with assisted circulation for severe cardiac failure.
In order to assess the adequacy of hepatic perfusion, hepatic venous oxygen saturation (ShvO2) was monitored in five patients undergoing mechanical circulatory support. Two patients were with intra-aortic balloon pumping (IABP), one was with a left ventricular assist device (LVAD), and two were with biventricular assist devices (BVAD). The mean ShvO2 values during assistance in each patient ranged from 27 to 84%. One patient with IABP showed persistently low ShvO2 (less than 30%) in spite of higher mixed venous oxygen saturation (SvO2) and subsequently developed hepatic dysfunction and multiple organ failure. In another patient, ShvO2 was 22% on average during LVAD, but increased to greater than 50% after adding a right ventricular assist device (RVAD). Of 3 patients with persistently high ShvO2 (44-80%, on average), only one developed hepatic failure--probably from prior severe shock--and the other two did not develop hepatic failure. There was a significant negative correlation between ShvO2 and splanchnic excess lactate, the parameter of anaerobic metabolism in the splanchnic area. In contrast, there was no correlation between simultaneously measured ShvO2 and SvO2 values when analyzed in a range of SvO2 below 70%. ShvO2 monitoring may be useful for evaluation of hepatic perfusion status in the management of critical patients, requiring assisted circulation.
Heart Failure↗
[Seven cases of eye involvement in adult with acute leukemia].
Seven acute leukemia cases with oculomotor paralysis and/or optic nerve paralysis were reported. Five cases were lymphoblastic and two were myelogenous leukemia. The average age was 30.7 years old and male to female ratio was 5:2. The eye involvement developed during hematological complete remission stage in 4 cases, and during relapsing stage in 2 cases. For the remaining case, eye symptom was an initial symptom of the disease. The computed tomography of ocular region showed tumorous involvement in 3 cases and no abnormality in other 4 cases. The white blood cell count on admission was over 30,000/microliters and leukemic cells occupied over 59% of bone marrow nucleated cells in 5 cases. Intrathecal administration, a whole brain irradiation and intra-arterial injection of Nimustin as well as standard systemic chemotherapy were performed against oculomotor and optic nerve involvement. Leucoencephalopathy occurred in 2 of 7 cases after intrathecal administration and irradiation. Since 1980, continuous treatment for prophylaxis of central nervous system leukemia have been done and this protocol was effective for meningeal involvement but not for ocular involvement.
Acute Disease↗
Calcitonin gene-related peptide in patients with endocrine tumors.
The plasma level of calcitonin gene-related peptide (CGRP) was measured by RIA in 41 patients with endocrine tumors [22 medullary thyroid carcinomas (MTC), seven parathyroid adenomas, four benign insulinomas, five carcinoids, and three pheochromocytomas]. Of the 22 patients with MTC, all five preoperative patients had elevated CGRP levels. The correlation between CGRP and calcitonin levels was significant (P less than .001) in 22 patients with MTC. Six of 19 patients with endocrine tumors other than MTC showed elevated CGRP levels. Immunohistochemical study showed that tumor tissues from all 22 cases of MTC and seven from other endocrine tumors contained immunoreactive CGRP. CGRP reactivity was found in only small numbers of tumor cells. Thus, although CGRP appeared to be a useful additional marker for MTC, the role of CGRP in the pathophysiology of endocrine tumors was not elucidated.
Adenoma↗
PDN-21: possible tumor marker for medullary thyroid carcinoma.
The plasma level of PDN-21 was measured by RIA in 10 patients with medullary thyroid carcinoma (MTC). All 10 patients with MTC had extremely elevated PDN-21 levels. The correlations between PDN-21, calcitonin gene-related peptide, and calcitonin, (all of which are calcitonin gene products) were significant (P less than .001) in the 10 MTC patients. This study suggests that PDN-21, as well as calcitonin, may be a useful marker for the detection of patients with MTC.
Adult↗
Characterization of an alkaline protease from Bacillus sp. no. AH-101.
The Bacillus sp. no. AH-101 alkaline protease showed higher hydrolysing activity against insoluble fibrous natural proteins such as elastin and keratin in comparison with subtilisins and Proteinase K. The optimum pH of the enzyme toward elastin and keratin was pH 10.5 and pH 11.0-12.0 respectively. The specific activity toward elastin and keratin was 10,600 units/mg protein and 3970 units/mg protein, respectively. The enzymatic activity was not inhibited by p-chloromercuribenzoic acid and iodoacetic acid. Carbobenzoxy-glycyl-glycyl-L-phenylalanyl chloromethyl ketone completely inhibited the caseinolytic activity, but 36% elastolytic activity remained. No inhibitory effect on caseinolytic and elastolytic activity was shown by tosyl-L-phenylalanyl-chloromethyl ketone, tosyl-L-lysine chloromethyl ketone, carbobenzoxy-L-phenylalanyl chloromethyl ketone, and elastatinal. The amino acid composition and amino terminal sequence of the enzyme were determined. The no. AH-101 alkaline protease was compared with subtilisin BPN', subtilisin Carlsberg, no. 221, and Ya-B alkaline proteases. Extensive sequence homology existed among these enzymes.
Amino Acid Sequence↗
Leakage of cytoplasmic enzymes from rat heart by the stress of cardiac beating after increase in cell membrane fragility by anoxia.
The effects of spontaneous beating after anoxia and the pumping stress induced by a left ventricular balloon on the leakage of myocardial enzymes from the isolated perfused rat heart were investigated. Beating of the heart was arrested by perfusion with high-K+ medium. When the beating was arrested during reoxygenation after anoxia, the leakage of lactate dehydrogenase (LDH) was significantly lower than during reoxygenation with spontaneous cardiac beating. After changing from K+ arrest to spontaneous beating by perfusion with low-K+ medium during reoxygenation, the leakage of LDH increased markedly. Imposition of left ventricular wall stress on the K(+)-arrested heart by repetitive passive distension during aerobic perfusion and after 20 min and 60 min of anoxia caused LDH leakages of 1.0, 4.6 and 21.0 units/g in 30 min, respectively. Under this mechanical stress, the release of LDH as a percentage of its total myocardial activity coincided well with that of cytoplasmic aspartate aminotransferase (AST), while the percentage release of mitochondrial AST was much less. These results appeared to indicate that the leakage of cytoplasmic enzymes during reoxygenation is accelerated by cardiac beating because of fragility of the cell membranes developing during the preceding anoxia.
Adenosine Triphosphate↗
Three-dimensional identification of actin filaments in phalloidin-treated rat livers by quick-freezing and deep-etching method.
An increase in microfilaments in phalloidin-treated hepatocytes of Wistar rats was identified three-dimensionally with myosin subfragment 1 (S1) on replica membranes, using the quick-freezing and deep-etching method. Almost all of the reticular microfilaments around the bile canaliculi and beneath the lateral cell membranes were decorated on their surfaces by S1 attachment. Some showed periodic structures. However, thinner filaments with diameters of 4-7 nm were not decorated by S1. Bundled intermediate filaments around the bile canalicular microfilaments and intermediate filaments localized among cell organelles had smooth surfaces without S1 decoration. The microfilaments decorated by S1 were attached directly to bundled intermediate filaments. The quick-freezing and deep-etching method is useful in analysing cytoskeletal pathology and can be applied to histochemical fields.
Actin Cytoskeleton↗
Ultrastructure of glomerular mesangial matrix by quick-freeze and deep-etch methods.
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Animals↗
Adenosine triphosphate compartmentation in the rat heart: a 31P spin-lattice relaxation study.
Longitudinal relaxation times (T1) of phosphorus compounds in the perfused rat heart and erythrocytes were measured using the 31P Driven-Equilibrium Single-Pulse Observation of T1 relaxation (DESPOT) method at 33 degrees C. Both creatine phosphate in the heart and the three phosphate groups of adenosine triphosphate (ATP) in erythrocytes showed single-exponential relaxation. The three phosphate groups of ATP in the heart, however, had two T1 components. The T1 values of the short and the long T1 components of the beta-phosphate of ATP were ca. 0.4 and 14 s, respectively. The fraction with the long T1 represented ca. 30% of the total ATP content. These results suggested that there were two major pools of intracellular ATP in the rat heart which could be determined by 31P NMR spectroscopy.
Adenosine Triphosphate↗