Subdural hematoma during allogeneic bone marrow transplantation for chronic myelogenous leukemia.
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Adult↗
Biomedical subjects
K Mishima
Publications and source records attributed to K Mishima.
Facilitatory and inhibitory processes in the thalamic ventrobasal nucleus of the rat.
Experiments were carried out on anesthetized rats to clarify the actions of the corticothalamic input on the thalamic ventrobasal neuron (VB). The field potentials and the unit activities were evoked in the VB by the electrical stimulation of the contralateral (cSCx) and ipsilateral somatosensory cortex (SCx), the thalamic radiation (TR), and the medial lemniscus (ML). The corticothalamic axons could be activated from cSCx via the ipsilateral SCx, with the result of a clear excitation followed by the inhibition of VB neurons. These VB responses were also evoked from SCx, TR, or even ML with other responses. Paired stimulation of these sites revealed that the corticothalamic input exerted facilitation on the succeeding corticothalamic input for 690 +/- 74.2 ms (n = 5). It was confirmed that these corticothalamic actions were abolished by the lesion of SCx. In contrast to the corticothalamic-induced VB responses, the VB responses to ML input received powerful inhibitory effects from ML or SCx for 1,150 +/- 35.4 ms (n = 5). It is concluded that the corticothalamic input can excite the VB neuron in a mechanism that differs from that of ML input.
Animals↗
Reappraisal of the corticothalamic and thalamocortical interactions that contribute to the augmenting response in the rat.
In urethane-anesthetized rats, low frequency electrical stimulation of the thalamic radiation (TR) evoked an augmenting response in the somatosensory cortex (SCx) which was followed by rhythmic slow waves. The augmenting response mainly consists of the incremental secondary response (II-response). Simultaneously, augmentation also occurs in the ventrobasal nucleus of thalamus (VB) on the late component responses, C- and D-waves, to TR stimulation. The latencies of these augmented responses were shorter for the C-wave and the accompanying unit discharges in the VB relay neurons than for the D-wave and the II-response. We hypothesized that the thalamo-cortico-thalamic reverberating circuit was crucial in generating the augmenting response in the SCx. To test this hypothesis, an attempt was made to block temporarily the corticothalamic glutamatergic transmission by means of microinjections of kynurenate (KYN), an antagonist of glutamate, into the VB with a dose of more than 2 mM. This local procedure blocked all of the augmenting phenomena completely with a full recovery after the duration that depended on the dose of KYN. Besides, in the stage of complete blocking of the II-response to the test TR stimuli, the augmentation was able to be restored by adding a short train of high frequency TR stimuli that mimicked a burst discharge of VB relay neurons. These results in support of the hypothesis would reappraise the functional significance of the reverberating circuit in augmentation that has recently been controversial.
Animals↗
Leptomeningeal dissemination of cerebellar pilocytic astrocytoma. Case report.
A case of surgically treated pilocytic astrocytoma in the cerebellar vermis is reported in a patient who subsequently demonstrated multiple subarachnoid nodular masses in the cerebrum and spinal cord 6 years after the initial surgery. The nodular tumors did not indicate a growth tendency on computerized tomography or magnetic resonance imaging over a 2-year observation period. The histology of the nodular masses in the cerebrum and spinal cord was similar to that of the original tumor. The bromodeoxyuridine labeling index indicated low proliferative activity (0.5%). The peculiar pattern of dissemination of the pilocytic astrocytoma is described.
Astrocytoma↗
Cell surface antigens expressed on polymorphonuclear cells in the peripheral blood from patients with inflammatory rheumatic diseases: two-color flow-cytometric analysis.
Cell surface antigens, such as CR3, Fc gamma RIII, cALLa and Leu 8 antigen, expressed on polymorphonuclear cells (PMN) in the peripheral blood (PB) are associated with certain functions of PMN. Functional alterations of PMN have been reported in some rheumatic diseases. In this study, therefore, the cell surface antigens were examined by 2-color flow-cytometry using monoclonal antibodies to clarify whether expressions of the antigens on PMN are abnormal in patients with rheumatic diseases including Behçet's disease (BD), rheumatoid arthritis (RA) and Sjögren's syndrome (SS). We found that expressions of CR3 and cALLa were increased on PB-PMN from patients with BD or RA, but not from those with SS. In BD, we further determined the phagocytic activity of PMN by a flow-cytometric method using fluorescent particles. The phagocytic activity was significantly higher in BD patients than in healthy controls, and correlated slightly with the expression of CR3 on PMN in the patients. In addition, prednisolone or colchicine seemed to decrease the expression of CR3 and/or cALLa in patients. The above results indicated that PB-PMN in BD and RA, but not SS, are phenotypically activated in vivo, and the activation probably reflects several cytokines and/or other stimuli to PMN produced in the inflammatory process.
Adult↗
[Abnormalities of beta spectrin with hereditary elliptocytosis in mother and child].
It is generally considered that abnormality of the erythrocyte membrane skeleton co elliptocytes. There are, however, few reports of beta spectrin variants. We found a new variant of beta spectrin in a child and her mother. This report is the first case of abnormality of beta spectrin in Japan. The propositus was an 8 month-old girl who was first examined by us in 1988. On laboratory findings, she showed anemia, increased reticulocyte count and decreased haptoglobin concentration. Both peripheral blood smears of patient and her mother showed typical elliptocytosis and they were diagnosed as hereditary elliptocytosis. SDS-PAGE patterns of the red cell membranes of the propositus and her mother were characterized by the presence of an abnormal component migrating immediately below the spectrin chains. We confirmed that the abnormal spectrin appeared clearly at the expense of normal beta chain. The abnormal spectrin (M.W. 216,000d) makes up 16% of the total beta chain. The inheritance of our case was autosomal dominant. The present case is considered as a new spectrin variant.
Adult↗
Localization of an endogenous ADP-ribose acceptor, p33, in polymorphonuclear cell granules in chicken liver interlobular connective tissue.
We investigated immunohistochemically the localization of p33, an endogenous substrate protein for an arginine-specific ADP-ribosyltransferase in chicken liver. Polymorphonuclear-pseudo-eosinophilic granulocytes (heterophils) in interlobular connective tissues of the liver were exclusively and strongly stained with the antibody against p33. Strong reactivity was associated with granules in cytoplasm of the heterophils. When the chicken liver nuclear fraction was washed, the transferase activity was released into the 600 x g supernatant fraction while a nuclear enzyme poly(ADP-ribose) synthetase was retained in the pellet fraction. These results indicate that p33 and probably also ADP-ribosyltransferase, found in the liver nuclear fraction [Tanigawa et al. (1984) J. Biol. Chem. 259, 2022-2029, Mishima et al. (1988) Eur. J. Biochem. 179, 267-273], originate from interlobular heterophils of the chicken liver.
Animals↗
Arginine-specific ADP-ribosyltransferase and its acceptor protein p33 in chicken polymorphonuclear cells: co-localization in the cell granules, partial characterization, and in situ mono(ADP-ribosyl)ation.
We have reported the purification and characterization of arginine-specific ADP-ribosyltransferase from hen liver nuclei [Tanigawa, Y. et al. (1984) J. Biol. Chem. 259, 2022-2029] and the DNA-dependent mono(ADP-ribosyl)ation of p33, an acceptor protein in the nuclei [Mishima, K. et al. (1989) Eur. J. Biochem. 179, 267-273]. In the present study, we obtained evidence that among various tissues and cells from chicken, polymorphonuclear cells, so-called heterophils, possess both the ADP-ribosyltransferase and p33 at high levels. Percoll density gradient centrifugation of the postnuclear fraction of the heterophils revealed the co-localization of ADP-ribosyltransferase with p33 in the granule fraction. The enzyme and p33 were purified approximately 219- and 3.77-fold, respectively, from postnuclear pellet fraction to apparent homogeneity. The properties of heterophil ADP-ribosyltransferase and p33 were compared with those of the liver enzyme and p33. The molecular mass of the heterophil enzyme was estimated by SDS-polyacrylamide gel electrophoresis to be 27.5 kDa. The enzyme activity was stimulated by a sulfhydryl agent and inhibited by lysolecithin, NaCl, and inorganic phosphate. The mono(ADP-ribosyl)ation of p33 was markedly enhanced by polyanion, such as DNA, RNA, or poly(L-glutamate). SDS-polyacrylamide gel electrophoretic analysis after limited trypsin proteolysis of p33s, purified from chicken heterophils and liver, showed much the same pattern. Thus, it appears that ADP-ribosyltransferase and p33 present in heterophils are identical to those in the liver, respectively. p33 is considered to be an in situ substrate for ADP-ribosyltransferase, since it was specifically mono(ADP-ribosyl)ated in permeabilized heterophils.(ABSTRACT TRUNCATED AT 250 WORDS)
ADP Ribose Transferases↗
Circadian rhythm disorders in sleep-waking and body temperature in elderly patients with dementia and their treatment.
Circadian rhythms in elderly patients with severe dementia and behavioral disorders such as wandering, agitation and/or delirium were examined. The subjects consisted of 24 patients with dementia (5 with senile dementia of Alzheimer's type and 19 with multi-infarct dementia), aged 56-89 (means = 75.5 +/- 8.7) and 8 control patients without dementia or with dementia of slight degree, aged 65-81 (means = 75 +/- 5.4). The sleep-wake state of the patients was judged every hour by nurses over periods of 1-4 mo and recorded in the form of a sleep diary. Oral temperature was recorded for 4-7 consecutive days. For the treatment of sleep-wake rhythm disorders, social interaction with nurses was encouraged in addition to drug therapy. The patients showed various types of sleep-wake disorders such as reversed day-night rhythm or irregular sleep-wake rhythm corresponding to a decreased amplitude of the sleep-wake rhythm. Circadian rhythm of oral temperature was irregularly disturbed in 59.0% of the patients in the dementia group and in only 12.5% of the patients in the control group. The effects of treatment by enforcement of social interaction with nurses was effective in reducing behavioral problems and sleep-wake rhythm disorder in 30.0% of the patients tested. However, body temperature rhythm disorganization remained after the treatment. These observations indicate that behavioral disorders such as delirium, agitation or wandering in patients with severe dementia might be closely related to disrupted biological rhythms of sleep-waking and the autonomic system (body temperature).
Aged↗
Methylmethacrylate implants: a scanning electron microscopic study.
Two methylmethacrylate orbital implants used for 34 and 5 years, respectively, were examined with a scanning electron microscope. One of the implants was a combination of a prosthesis and an implant containing a magnet. The magnetic force had decreased markedly, and rust crystals were apparent. The methylmethacrylate surface was irregular and rough.
Eye Diseases↗
[Echocardiographic assessment of the etiology of aortic regurgitation in the elderly].
We performed echocardiographic studies in 189 elderly subjects aged over 65. Aortic regurgitation (AR) was detected by real time 2-D Doppler system. 189 patients were classified into 5 groups based on the severity of AR (AR-: 81 pts, AR1+: 32 pts, AR2+: 44 pts, AR3+: 27 pts, AR4+: 5 pts). The diameter of the aortic root, the angle (theta) between the aortic wall and interventricular septum and echo intensity of aortic valve were measured by 2-D echocardiography. There was no relation between the severity of AR and angle theta. Diameters of aortic root were significantly increased in AR3+ cases as compared with AR- and AR2+. Systolic blood pressure was significantly increased in AR4+ cases as compared with AR-, AR1+, and AR2+. Diastolic blood pressure was also decreased in AR3+ cases as compared with AR-. Echo intensity of aortic valve was increased in patients with AR. It was thought that increased diameters of the aortic root in patients with severe AR were induced from the long-standing AR, and that increased systolic blood pressure and decreased diastolic blood pressure in severe AR were caused by hemodynamic changes due to AR. Therefore, we concluded that AR in the elderly was caused by degeneration and/or deformity of the aortic valve.
Aged↗
Circadian rhythm of melatonin secretion and body temperature in a patient with seasonal affective disorder.
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Aged↗
Vitamin B12 treatment for sleep-wake rhythm disorders.
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Adolescent↗
[Clinical study of miconazole on deep-seated fungal infections].
An investigation was made on the efficacy and the safety of miconazole (MCZ) in the treatment of deep seated mycosis. The drug was administered through intravenous drip infusion at dose levels of 800 to 2,000 mg/day to 21 cases of confirmed mycosis for which causative organisms was identified and to 32 cases to which other antibiotics considered to be appropriate had been administered at febrile stages but had failed to take effect, hence mycoses were strongly suspected. The overall clinical efficacy rate was 84.3% (43/51). Treatments were "remarkably effective" in 6 cases, "effective" in 37, "not effective" in 8 and "indeterminable" in 2. The efficacy rates were 100% (21/21) in the confirmed mycosis cases and 73.3% (22/30) in the suspected mycosis cases. The mycological efficacies in the cases for which causative strains were identified were: disappeared in 14 (66.7%), decreased in 4 (19%), unchanged in 2 (9.5%) and unknown in 1 (4.8%), thus the overall disappearance ratio was 70% (14/20). Chest X-ray showed the disappearance of shadow in 1 patient and improvements in 14 of 23 patients examined. Adverse reactions were observed in 5 of the 53 cases (9.4%). From these results, MCZ may be considered as a highly useful drug not only in the treatment of deep mycosis but also in cases for which mycosis is strongly suspected.
Adolescent↗
Vitamin B12 treatment for sleep-wake rhythm disorders.
Vitamin B12 (VB12) was administered to two patients suffering for many years from different sleep-wake rhythm disorders. One patient was a 15-year-old blind girl suffering from a free-running sleep-wake rhythm (hypernychthemeral syndrome) with a period of about 25 h. In spite of repeated trials to entrain her sleep-wake cycle to the environmental 24-h rhythm, her free-running rhythm persisted for about 13 years. When she was 14 years old, administration of VB12 per os was started at the daily dose of 1.5 mg t.i.d. Shortly thereafter, her sleep-wake rhythm was entrained to the environmental 24-h rhythm, and her 24-h sleep-wake rhythm was maintained while she was on the medication. Within 2 months of the withholding of VB12, her free-running sleep-wake rhythm reappeared. The VB12 level in the serum was within the normal range both before and after treatment. The other patient was a 55-year-old man suffering from delayed sleep phase syndrome since 18 years of age. After administration of VB12 at the daily doses of 1.5 mg, his sleep-wake rhythm disorder was improved. The good therapeutic effect lasted for more than 6 months while he was on the medication.
Adolescent↗
[Frequency of the developmental disturbances of tooth structure].
In permanent and deciduous dentitions, the frequency of congenitally missing teeth, supernumerary teeth, conical teeth, fused teeth, germinate teeth, abnormal tubercles (basal ridge of incisor or canine, central cusps of molars, Carabelli's cusp, protostylid, and para-molar tubercles), and enamel hypoplasia (white spots, pigmentation, and enamel defects) were surveyed. Furthermore, mesio-distal and bucco-lingual dimensions of the crowns were measured and the relationship between developmental disturbances of dental hard tissue and tooth size was examined. For the deciduous dentition, the frequency of children with congenitally missing teeth, conical teeth and fused teeth was 7.2%, 1.1% and 5.3%, respectively. Enamel hypoplasia appears with the following frequency; white spots (16.0%), pigmentation (6.4%), and enamel defects (5.2%). Mesio-distal widths of the upper canine and lower lateral incisors of the children with congenitally missing teeth was significantly smaller than the standard values. For the permanent dentition, congenitally missing teeth, conical teeth and fused teeth were detected in 5.7%, 3.0%, and 0.5% of the children, respectively. The frequency of children with basal ridge, central cusps, Carabelli's cusp, protostylid, and para-molar tubercles was respectively, 1.1%, 2.6%, 7.1%, 0.3% and 1.3%. Children with central cusps or Carabelli's cusp tended to have larger crowns, while children with congenitally missing teeth or conical teeth tended to have smaller teeth. As for enamel hypoplasia, white spots were detected in 24.9% of the children, and pigmentation was in 8.1%, and enamel defects were in 9.2%. These results indicate that abnormality of tooth number and tooth morphology correlate with the tooth size and this tendency is more striking in permanent dentition than in deciduous dentition.
Child↗
[Methylprednisolone-pulse therapy in a patient with rheumatoid arthritis and diffuse interstitial pneumonia/pulmonary fibrosis].
A forty-eight year-old female with rheumatoid arthritis developed cough, sputum and dyspnea. Chest X-ray film demonstrated bilateral diffuse interstitial pneumonia and pulmonary fibrosis. Laboratory findings were as follows: ESR 29 mm/h, CRP 3.86 mg/dl, RA test (+), RAHA (-) and WBC 7200/mm3. Marked hypoxemia (po(2)45 Torr) was demonstrated by blood gas analysis. Asymptomatic pulmonary fibrotic lesions which preceded articular symptoms were identified on her previous chest X-ray films. Methylprednisolone-pulse therapy (1g/day, for 3 days) was repeated three times with a 2-week interval. The treatment rapidly improved both pulmonary symptoms and chest X-ray findings. Although the fibrotic shadows on chest X-ray did not completely disappear, her conditions have been maintained well under the treatment with prednisolone (10mg/day) plus D-penicillamine (200mg/day).
Arthritis, Rheumatoid↗
[Sudden cardiac arrest during percutaneous nephrostolithotomy (PNL) under epidural anesthesia].
There have been few major complications of percutaneous nephrostolithotomy (PNL) reported. We recently experienced cardiac arrest during PNL under epidural anesthesia. The patient was a 52 year old man weighing 64 kg who had been suffering from right renal pelvic stone for years. He was scheduled for PLN under epidural anesthesia. Analgesia was obtained to the level of Th6. The operation proceeded uneventfully for about 60 min. By this time, he suddenly complained nausea, and hypotension with bradycardia occurred. Blood pressure and pulse rate returned immediately to the normal level by IV atropine and ephedrine. But after three minutes, blood pressure and pulse rate went down again. This hypotension with bradycardia was unresponsive to epinephrine, calcium chloride and sodium bicarbonate. This was followed by asystole. Resuscitation was successful with the addition of epinephrine, calcium chloride, and sodium bicarbonate about 15 min after cardiac massage had started. The patient was, on the fifth postoperative day, with no evidence of impairment of renal, cardiac and respiratory functions but a slight impairment of neurologic function. Several possible causes for this cardiac arrest and anesthetic management of percutaneous nephrostolithotomy are discussed.
Anesthesia, Epidural↗