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K Kitazawa

Publications and source records attributed to K Kitazawa.

At least 19 recordsLinked to original sources
PubMed2000

[A case of Down syndrome with moyamoya syndrome presenting extensive multiple cerebral infarction during measles infection].

We report a case of a 2-year-old boy with Down syndrome complicated by Moyamoya syndrome who developed extensive multiple cerebral infarction after status epilepticus on the third day of a measles infection. MR angiography revealed the occlusion of the terminal portion of the bilateral internal carotid artery and the basilar artery. Fever, dehydration, activation of coagulation associated with the infection, relatively decreased cerebral blood flow during status epilepticus, and central nervous invasion of the measles virus may have played a role in the development of the infarction. Moyamoya like cerebrovascular lesions occur more often and is more aggressive in children with Down syndrome than in the general pediatric population, and their clinical presentation is always the infarction type. In patients with Down syndrome complicated by Moyamoya syndrome, an early diagnosis and prevention of infarction are important.

Aspirin↗
PubMed1999

A case of primary antiphospholipid antibody syndrome with acute renal failure showing thrombotic microangiopathy.

An 18-year-old woman complained of fever and edema and was admitted to Showa University Hospital for treatment of thrombocytopenia and deteriorating renal function. Laboratory studies demonstrated the presence of lupus anticoagulant (LA), prolongation of prothrombin time, hemolytic anemia, a negative Coombs' test, the absence of antinuclear antibodies, and a normal fibrinogen level. Renal biopsy revealed mesangial hypercellularity, severe endocapillary cell damage, and double contour of the basement membrane walls. Immunofluorescence studies demonstrated focal, peripheral, and finely granular deposits for IgG, IgM, and IgA but were negative for fibrinogen. Electron microscopy showed glomerular capillary loops with subendothelial widening and subendothelial deposits, mesangiolysis, mesangial interposition, and marked luminal narrowing. Biopsy findings were consistent with thrombotic microangiopathy. The patient was treated with hemodialysis, methylprednisolone pulse therapy, and dipyridamole. After treatment, LA disappeared, the prothrombin time became normal, and renal function improved. The renal lesions in this patient were caused by primary antiphospholipid antibody syndrome. This case strongly suggests an important causal relationship between LA and renal lesions in thrombotic microangiopathy. We present this case to promote understanding of the pathogenesis of primary antiphospholipid antibody syndrome.

Acute Kidney Injury↗
PubMed1998

In vitro biotransformation of atrazine by rat liver microsomal cytochrome P450 enzymes.

We studied atrazine (ATZ) metabolism in male and female rat liver microsomes in vitro, and the major metabolite was deisopropylatrazine (DeiPr-ATZ) with deethylatrazine (DeEt-ATZ) and 1-hydroxyisopropylatrazine (iPrOH-ATZ) as minor metabolites in both sexes. The enzyme kinetics of ATZ biotransformation were examined by means of Eadie-Hofstee analyses. Although no remarkable sex difference of Michaelis Menten values for each pathway was observed, Cl(int)S (Vmax/Km) for DeiPr-ATZ, DeEt-ATZ and iPrOH-ATZ were slightly higher in female than in male rats. The formation of DeiPr-ATZ, DeEt-ATZ and iPrOH-ATZ from ATZ was substantially inhibited by SKF-525A, metyrapone, diallyl sulfide, 7-ethoxycoumarin, benzphetamine, nicotine, testosterone and lauric acid in both sexes. Cimetidine effectively inhibited the formation of all metabolites in male rats. On the other hand, the inhibition rates of the formation of DeiPr-ATZ and iPrOH-ATZ by cimetidine in female rats were lower than those in male rats, and DeEt-ATZ was hardly affected by the chemicals. In contrast with the results for cimetidine, the inhibition of ATZ biotransformation by bufuralol was more effective in female than in male rats. Anti-rat CYP2B1 and CYP2E1 antibodies effectively inhibited DeiPr-ATZ, DeEt-ATZ and iPrOH-ATZ formations in both sexes. Anti-rat CYP2C11 antibody also inhibited the three metabolites in both sexes, with the inhibition rates higher in male than in female rats, similar to cimetidine. In the case of anti-rat CYP2D1 antibody, the inhibitory effect on ATZ biotransformation in male rats was less than that in female rats. On the other hand, anti-rat CYP1A2, CYP3A2 and CYP4A1 antibodies did not affect the ATZ biotransformation in either sex. There was no significant correlation between the formation rate of ATZ metabolites and P450 isoform levels in either sex. These results may mean that CYP2B2, CYP2C11, CYP2D1 (only iPrOH-ATZ formation) and CYP2E1 in male rats, and CYP2B2, CYP2D1 and CYP2E1 in female rats are involved ATZ metabolism in liver, and that the substrate specificity of P450 isoforms for ATZ is broad.

Animals↗
PubMed1998

Guillain-Barré syndrome associated with IgG anti-GM1b antibody subsequent to Mycoplasma pneumoniae infection.

Sera from patients with Guillain-Barré syndrome (GBS) frequently have antibodies to various gangliosides. We report a girl with GBS after Mycoplasma pneumoniae infection who had serum IgG antibody to GM1b ganglioside as well as the cold agglutinins. The cold agglutinins are polyclonal IgM autoantibodies to 'I' antigen on erythrocytes. Ganglioside GM1b contains the terminal moiety shared with sialylated I antigen, a main receptor for M. pneumoniae. In this patient, the anti-GM1b antibody may be elicited in a similar mechanism producing anti-I antibody, and functioned in the development of GBS.

Agglutinins↗
PubMed1998

Color Doppler ultrasound imaging in the emergency management of an intracerebral hematoma caused by cerebral arteriovenous malformations: technical case report.

OBJECTIVE AND IMPORTANCE: Ruptured arteriovenous malformations (AVMs) are important causes of spontaneous intracerebral hemorrhages. This is a report of emergency hematoma removal, avoiding damage to the nidus of the AVM, using intraoperative color Doppler imaging. CLINICAL PRESENTATION: A 38-year-old woman suddenly presented with coma. The patient underwent emergency surgery immediately after admission, without preoperative angiographic examination, because of progressive neurological deterioration caused by a massive hematoma in the right basal ganglia, as diagnosed with computed tomographic scanning. INTERVENTION: A right frontotemporoparietal craniotomy was performed. Intraoperative ultrasound imaging with a color Doppler system (EUP-NS32, 5 MHz; Hitachi Medical, Tokyo, Japan) clearly demonstrated a nidus complex in the hematoma. Based on the imaging, effective decompression of the hematoma was performed without damage to the AVM complex. CONCLUSION: Color Doppler imaging (with real-time availability) of an atypical hematoma provided significant information on the vascular lesion causing the hematoma and could reduce the surgical risks during emergency evacuation of large intracerebral hemorrhages resulting from ruptured AVMs.

Adult↗
PubMed1998

Aneurysm surgery in Asia--Japanese situation.

This report is based on the results of the questionnaires conducted for the Japan Stroke Surgery Meeting 1996 (President: S. Kobayashi). The questionnaires were sent to all neurosurgical training institutions approved by The Japan Neurosurgical Society, numbering 959. The response rate was 54.2% (520 institutions). All statistics dealt with cases from January 1995 to December 1995. The total number of aneurysm surgery performed was 13,166. The average operative case number per institution during the year was 25. About 20% of the institutions exceeded 35 cases. Of all operative cases, 76.3% were ruptured aneurysms and 23.7% were nonruptured. Giant aneurysms were 2.9%; dissecting aneurysms 2.4%. Surgical procedures performed were clipping in 90.3%, wrapping in 5.2%, proximal ligation 1.6%, and bypass in 0.7%. Intravascular surgery was performed for 2.3% of the cases. Sugita clips were mainly used in 80.5% of the institutions, Yasargil clips in 6.6%, and both in 12.9%. For anterior communicating artery aneurysms pterional approach was mainly used in 81.0% of the institutions, interhemispheric in 7.2%, and both in 11.7%. For basilar terminal aneurysms, pterional approach was mainly used in 88.3% of the institutions, subtemporal approach in 6.6%, and both in 5.1%. The nonoperative cases included 24.9% of the ruptured aneurysms, 31.7% of the unruptured aneurysms, 38.4% of the giant aneurysms, and 52.1% of the dissecting aneurysms. The above statistics suggest that aneurysms are treated in Japan in most training institutions and that open surgical treatment is still the main procedure of choice.

Humans↗
PubMed1998

A case of immunotactoid glomerulopathy with unusual microtubular deposits.

A 57-year-old man with monoclonal gamma-globulinemia was admitted because of edema and proteinuria. A renal biopsy specimen showed lobular glomerulonephritis associated with deposition of material that was positive for IgG, C3, C1q, fibrin, kappa light chain, and lambda light chain but was not stained by Congo red. Glomeruli showed massive electron-dense deposits with two kinds of unusual, highly organized crystalline structures in the mesangial matrix and peripheral capillary loops. Clinically, the patient had nephrotic syndrome, microscopic hematuria, and hypertension. No Bence-Jones protein or cryoglobulin was found in the urine or serum. Immunoelectrophoresis of blood and urine revealed increased IgG-lambda paraprotein, but no free light chains were found. This case was not associated with amyloidosis, systemic lupus erythematosus, light chain deposition disease, cryoglobulinemia, or multiple myeloma. Immunotactoid glomerulopathy was diagnosed. Treatment with oral prednisone was effective for the management of nephrotic syndrome and renal dysfunction. Glomerular deposition of two kinds of microtubular structure in immunotactoid glomerulopathy has rarely been reported.

Glomerulonephritis↗
PubMed1997

Non-genomic mechanism of 17 beta-oestradiol-induced inhibition of contraction in mammalian vascular smooth muscle.

17 beta-Oestradiol (E2) at 0.1-10 microM directly inhibited various tonic and phasic smooth muscle contractions. The mechanism(s) of oestrogen-induced inhibition of contraction was studied using intact and permeabilized strips and isolated single cells of smooth muscle. 2. In endothelium-denuded vascular smooth muscle, E2 attenuated high K(+)-induced force development and myosin light chain phosphorylation, and produced rapid and reversible relaxation. There were no significant differences in these inhibitory effects between tissue types (femoral artery vs. portal vein), species (rat vs. rabbit) or sexes. 3. The inhibitory potencies of several steroidal and non-steroidal oestrogen analogues were examined and their effects were for the most part stereo-specific. However, two steroids with negligible affinities for the nuclear oestrogen receptor also strongly inhibited high K(+)-induced contraction. 4. Genomic modulators including a protein synthesis inhibitor, an RNA synthesis inhibitor, and oestrogen receptor antagonists did not affect the inhibitory actions of E2. Inhibitors of cyclic nucleotide-dependent protein kinases did not reduce the E2 effect. 5. Ca2+ release from intracellular stores by agonists and by inositol 1,4,5-trisphosphate (IP3) does not appear to be modulated by E2. Neither pretreatment with ryanodine nor with thapsigargin affected the E2-induced inhibition of high K(+)-induced contraction. 6. E2 had no effect on either normal or GTP gamma S-increased Ca2+ sensitivity of the regulatory and contractile apparatus. 7. E2 and its analogues rapidly inhibited voltage-dependent L-type Ca2+ channel currents in isolated smooth muscle cells. Repetitive stimulation was not required for E2-induced inhibition of the currents. 8. This study strongly suggests that at pharmacological concentrations oestrogen primarily reduces Ca2+ influx through inhibition of L-type Ca2+ channels in a non-genomic manner and decreases myosin light chain phosphorylation and contraction of smooth muscle.

Animals↗
PubMed1996

The relationship of adhesion molecules and leukocyte infiltration in chronic tubulointerstitial nephritis induced by puromycin aminonucleoside in Wistar rats.

We studied the expression of adhesion molecules on infiltrating leukocytes and tubular cells in chronic tubulointerstitial nephritis associated with puromycin aminonucleoside (PA) nephrosis. Rats received injections of PA (2 mg/100 g body wt) weekly for the first 3 weeks and every other week thereafter. Rats were killed at 0, 3, 5, 8, and 12 weeks after the start of injections. From the third to the fifth week, the initial infiltrating cells in interstitial tissue were mainly CD4+ T lymphocytes. At the fifth week, ICAM-1, CD44, and hyaluronate were expressed on infiltrating cells in interstitial tissue. At the eighth week, the number of infiltrating cells reached a peak and consisted of T lymphocytes (CD4, CD8) and macrophages (ED1, MHC class II, CD11b, and CD18). The severity of interstitial infiltration was correlated with the degree of proteinuria and with ICAM-1 expression. Our results suggest that CD4+ T lymphocytes may contribute to the production of initial tubular injury. Expression of ICAM-1 helps mononuclear cells migrate to the interstitium. In addition, expression of CD44 and hyaluronate may play important roles in the chronicity of tubulointerstitial nephritis.

Animals↗
PubMed1995

Infantile subdural fluid collection: diagnosis and postoperative course.

The authors reviewed 47 cases of infantile subdural fluid collection with regard to diagnosis and postoperative course after placement of a subdural-peritoneal shunt. CT scan with contrast enhancement proved to be an important diagnostic modality, showing vessels in the subarachnoid space as high-density spots. Utilizing this technique, we were able to differentiate the following varieties of fluid collection: (1) subdural fluid collection, in which enhancing vessels were seen on the brain surface, (2) subarachnoid fluid collection, in which vessels were on the inner table of the cranium, and (3) coexistence of subdural and subarachnoid fluid collections, in which vessels were between the inner table of the cranium and the brain surface. The postoperative course of subdural fluid collection was characterized as follows: (1) the subdural fluid collection decreased first, with increased subarachnoid fluid collection; (2) the subarachnoid fluid collection remained after the disappearance of subdural fluid collection; and (3) the brain expanded again later. Subdural fluid collection disappeared about 1 month after the shunt operation, which could lead occlusion of the shunt system. Postoperative enlargement of the subarachnoid space was an early indicator of the efficacy of the subdural-peritoneal shunt.

Cerebral Angiography↗
PubMed1995

[Guillain-Barré syndrome associated with external ophthalmoplegia, consciousness disturbance, and extensor plantar responses: an overlap between Guillain-Barré syndrome and Bickerstaff's brainstem encephalitis].

A 14-year-old girl developed diplopia and ataxic gait following upper respiratory tract infection. On day 3, she became lethergic, but was easily roused on stimulation. Neurologic examinations showed external ophthalmoplegia, tetraplegia, tendon areflexia, and extensor plantar responses. CSF protein was 93 mg/dl with normal cellurality on day 25. Serum in the acute phase of her illness had autoantibodies to gangliosides GQ1b and Ga1NAc-GD1a. An EEG showed bilateral theta activity. Results of ABR, SEP and blink reflexes suggested the presence of intramedullary brainstem lesion. She received plasmapheresis on days 4, 5 and 6. Neurological signs immediately improved. Five months after onset of neurological symptoms, she had no neurological abnormalities except for tendon areflexia. Electrophysiologic studies returned to normal concurrently with her clinical improvement. This patient demonstrates an overlap between Guillain-Barré syndrome and Bickerstaff's brainstem encephalitis.

Adolescent↗