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Biomedical subjects

K Furihata

Publications and source records attributed to K Furihata.

At least 109 records · Page 6Linked to original sources

[Genetic analysis for hereditary disorders].

Many genetic abnormalities responsible for hereditary disorders has been localized on chromosomes by positional cloning. Identification of RFLP and VNTR markers facilitated the process. Once mutations have been fully characterized, prenatal or presymptomatic diagnosis can be easily made by using polymerase chain reaction (PCR). Since no curable treatments are available for most of hereditary disorders, the following premises should be well understood when performing genetic analysis; 1) association of the mutation to look at and the hereditary disorder must be clearly demonstrated, 2) patients and their families must have opportunities to have counseling on the disease by experts in the field. 3) everybody must respect the will of patients and families to have or not to have genetic analyses, 4) every information should be securely kept and privacy of patients and families must be fully protected, and 5) genetic analysis procedures must be accurate and reliable. Recently, we characterized dysfibrinogenemia Matsumoto I. The proband was asymptomatic and only screening coagulation tests revealed mild prolongation of prothrombin time. Its functional level was as low as 5% of its immunologically determined level. Genetic analysis identified an amino acid substitution of gamma 364Asp-->His. Living-related liver transplantation performed to treat a patient with familial amyloid polyneuropathy is briefly described in this article.

Afibrinogenemia↗

[A patient with Kennedy-Alter-Sung syndrome showing cardiomyopathy].

A 31-year-old man with a history of progressive muscular atrophy and weakness from around 22 years of age, recently experienced arrhythmia. On examination he showed gynecomastia and slight proximal weakness in both upper and lower extremities. Androgen receptor gene analysis showed an increased number of tandem CAG repeats in exon 1, thus leading to a diagnosis of Kennedy-Alter-Sung (KAS) syndrome. Cardiological investigations including echocardiography, scintigraphy and catheterization disclosed dilated cardiomyopathy. Cardiac muscle biopsy showed myocardial cell degeneration. KAS syndrome is causatively related to androgen receptor gene abnormality. This receptor is widely distributed throughout human body, including the genital tract, spinal cord, liver, and heart. Androgen receptor dysfunction may induce cardiac muscle involvement in patients with KAS syndrome, producing the previously unknown pathophysiology of cardiomyopathy.

Adult↗

Familial amyloid polyneuropathy in Taiwan: identification of transthyretin variant (Leu55-->Pro).

We report a family with familial amyloid polyneuropathy (FAP), showing an early-onset and a fatal outcome before age 30. Transthyretin (TTR) gene analysis showed one point mutation (T-->C change) in the second base of codon 55, and the corresponding amino acid substitution of proline (Pro) for leucine (Leu) was confirmed at the protein level. This is the first FAP family of Taiwanese origin demonstrating a causative gene abnormality, and FAP with TTR-Pro55 was considered to be more serious compared with other forms of FAP.

Adolescent↗

Restriction fragment length polymorphism (RFLP) of genomic DNA of Moraxella (Branhamella) catarrhalis isolates in a hospital.

Epidemiological typing, based on restriction fragment length polymorphism (RFLP) by pulsed-field gel electrophoresis (PFGE), was attempted for the 38 clinical isolates of Moraxella catarrhalis obtained at Shinshu University Hospital during the years 1987 and 1993. Digestion with SmaI or NotI generated well separable, 12 to 5 genomic DNA fragments ranging from 1,000 kb to 30 kb and the strains could be classified into 14 or 13 types, respectively. The electrophoretic profile differed with the strain in most of them and was hence useful to distinguish the each strain. Investigation for their RFLP have, however, suggested that majority of them, including the type strain ATCC25238, may have derived from a common ancestor.

Electrophoresis, Gel, Pulsed-Field↗

Inactivation of the macrolide antibiotics erythromycin, midecamycin, and rokitamycin by pathogenic Nocardia species.

A survey of five Nocardia spp. with respect to susceptibility towards three macrolides (erythromycin, rokitamycin, and midecamycin) showed that the Nocardia spp. have different susceptibility profiles. Most of the resistance was due to the inactivation of the macrolides by phosphorylation, glycosylation, reduction, deacylation, or a combination thereof.

Biotransformation↗

[Genetic analysis and a new therapy for a hereditary disease: familial amyloid polyneuropathy].

Familial amyloid polyneuropathy (FAP) is a hereditary disorder with autosomal dominant trait and is characterized by the accumulation of transthyretin at the nervous systems. The disorder mostly becomes overt in the fourth decade of life among affected individuals. Treatment of FAP has been directed toward the relief of symptoms and not intended to eliminate the yet unknown cause of this disorder. Recently, Val30 to Met substitution in the transthyretin gene was found among the patients with typical FAP. This enabled us to genotype affected individuals by PCR-RFLP and paved the way to the treatments directed to lower the levels of abnormal transthyretin in patients. In 1990, a Swedish group successfully performed liver transplantation to patients with FAP. This report was followed by more than 60 cases of liver transplantation to FAP patients in the Western hemisphere. Herein, I describe the first case of living-related liver transplantation to an FAP patient at Shinshu University Hospital. The patient was a 31-year-old female, whose father and aunt died of typical FAP in their fifth decade. She was suffering from severe pains in her lower extremities and nausea and vomiting. PCR-RFLP of her transthyretin gene revealed that she was heterozygous for Val to Met substitution at codon 30. In 1993, she was transplanted the left lobe of liver from her elder sister, who was genetically free of the disorder. Two weeks after the transplantation, serum Met30-transthyretin levels fell below 5% of the initial level. Symptoms due to peripheral nervous system and gastrointestinal tract were relieved after the transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[A study of low density lipoprotein in a patient with hyper-high density lipoprotein cholesterolemia with normal cholesterolester transfer protein].

We examined a patient with hyper-cholesterolemia with a high level of HDL2 and LDL-cholesterol in serum. The metabolism of lipoproteins in this case was different from that in well-known hyper-high density lipoproteinemia or hyper-low density lipoproteinemia, because the patient had normal levels of cholesterolester transfer protein, lipoprotein lipase and hepatic triglyceride lipase activity. This study describes the characterization of LDL obtained from the patient's serum. LDL from the patient was separated by ultracentrifuge, and analyzed by gradient PAGE. The molecular weight of two LDL from the patient have been estimated to be approximately 1250 and 1450kDa by polyacrylamide gel electrophoresis, and were larger than those of normal individuals and patients with typical hypercholesterolemia (approximately 1150kDa in molecular weight). The LDL from the patient was separated into three fractions by HPLC, and their lipid composition was not significantly different from that of normal LDL. The high level and large size of LDL from the patient may be caused by a reduction in the transfer of cholesterol from LDL to HDL2, or an equilibrium of cholesterol with the increased HDL2.

Aged↗

[Detection of anti-granulocyte antibodies using flow cytometry].

To detect anti-granulocyte antibodies (AGAs) in the sera of granulocytopenic patients is important to study the mechanism of the disease. In this report, we studied neutrophil associated immunoglobulin (NAIg) and neutrophil binding immunoglobulin (NBIg) in patients' sera using flow cytometry (FCM). We investigated the interference of circulating immune complexes (CIC) on measuring the NAIg and NBIg. No apparent effect of CIC was observed at concentrations up to 140 micrograms/ml. NAIg and NBIg were semiquantitated by determining the relative fluorescence intensity (RFI) on a flow cytometer and the normal ranges of NAIg and NBIg were less than 15 RFI and less than 10 RFI, respectively. Of 100 sera from patients with neutropenia, 5 were positive for NBIg and 3 of them were positive for granulocyte-specific antibodies. One serum of a patient with benign chronic neutropenia showed clear specificity for NA1 alloantigen but the other 4 AGAs were not specific for NA alloantigen system. Our NAIg, NBIg screening procedure, including NA specificity testing of NBIg and detection of reactivity with normal lymphocytes using FCM, is simple and useful for measuring and studying serological and immunological characteristics of AGAs.

Autoantibodies↗

[Within-day and between-day quality control of white blood cell differential by moving-average method].

Since its first appearance several years ago, automated blood cell analyzers capable of calculating white blood cell (WBC)-differential by flowmetric system have been widely accepted. Although these analyzers are fast and reliable, any other suitable quality control (QC) methods than Levey-Jennings (X) method have not been established yet. In this report, we provide evidence that Bull's moving-average (MA) method is extremely useful for within-day and between-day QC of WBC-differential assayed with flowmetric NE-7000 system. Monocyte(Mon) content in the control blood cells used in X method were varied among each lot, and the percentage of neutrophil(Neu) showed a tendency to decrease, while the percentage of Mon and basophil(Bas) showed a tendency to increase during storage. On the other hand, real-time QC of WBC-differential was enabled by the MA method that calculated mean value of each batch consisting of twenty samples. Within-day and between-day coefficient of variation (CV%) of WBC-differential controlled by the MA method was ranged from 5.0 for Neu to 12.5% for eosinophil(Eos) in patients' samples, and from 2.37% for Neu to 11.57% for Mon in healthy adults' samples. Therefore, we set up the limit of CV% for QC of WBC -differential by the MA method as follows: 10% for Neu, 20% for Lymphocyte, 30% for Mon, 20% for Eos and 20% for Bas. In addition, we report our experience of one occasion when sudden decrease of Mon to below the lower limit of the CV% was indicated by the MA method and suitable adjustment was made at once. The change was not detected by X method. In conclusion, the MA method is applied to real-time, daily and weekly/monthly QC of WBC-differential.

Adult↗

Study on the expression of ABH antigens on platelets.

We recently examined a case of refractoriness to HLA-matched, ABO-incompatible platelet transfusions. The transfused platelets that were rapidly cleared from the circulation of the recipient expressed an amount of B antigen more than 20 times that expressed by the blood group B platelets that were successfully transfused to the recipient. These observations led us to conduct enzyme-linked immunosorbent assay (ELISA) and immunoblotting studies of the amount of blood A and B antigens expressed on the surface of platelets from randomly selected donors. The donors were clearly classified, according to the amount of A or B antigen expressed on their platelets, into two phenotypes, the high-expression and low-expression phenotypes. By ELISA, 7% of the examined donors were determined as belonging to the high-expression phenotype of either A or B antigen. The high-expression phenotype was independent of secretor phenotype. In transferase activity assay, a donor with high expression of B had increased B transferase activity in her serum, which suggested that the high-expression phenotype might be under the control of the glycosyltransferase gene. Family studies showed a dominant inheritance pattern of the high-expression phenotype. This report provides evidence that the expression of ABH antigens on platelets is genetically determined and that the ABO group should be given some attention in platelet transfusions.

ABO Blood-Group System↗