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Biomedical subjects

K Murai

Publications and source records attributed to K Murai.

At least 19 recordsLinked to original sources

High HTLV-I proviral DNA level associated with abnormal lymphocytes in peripheral blood from asymptomatic carriers.

The level of proviral DNA in peripheral blood mononuclear cells from a representative group of asymptomatic HTLV-I carriers in Miyazaki district, an HTLV-I endemic area in Japan, was determined by a single-cycle polymerase chain reaction method (PCR). Of 217 subjects, 26% had a high level of proviral DNA, 43% a medium level, 18% a low level, and 13% an undetectable level. In the high-DNA group, 60% had at least 0.6% abnormal lymphocytes on peripheral blood smears, significantly higher than in those with low DNA levels (19%). This association was present for men of all ages and for women under 55. Men were more than twice as likely to have abnormal lymphocytes as well as high levels of proviral DNA. These differences may reflect different host responses to the virus by sex or by the time or route of infection. This study supports the utility of PCR for molecular screening in epidemiologic studies of the natural history of HTLV-I, and may lead to the identification of those carriers who are at greatest risk of developing HTLV-I-induced malignancy.

Age Factors

Familial primary biliary cirrhosis associated with impaired concanavalin A-induced lymphocyte transformation in relatives. Two family studies.

The familial occurrences of biochemical and immunological abnormalities and histocompatibility antigens were studied in 18 healthy first-degree relatives of patients with primary biliary cirrhosis (PBC) in two families. In each of these two families, there were two members who suffered from PBC. All relatives had normal serum aspartate aminotransferase, alkaline phosphatase, bilirubin, total cholesterol, and immunoglobulins except the two, who had a mild elevation of alkaline phosphatase without cholestasis. Autoantibodies were present in some relatives; five (28%) for antithyroglobulin antibody and antithyroid microsomal antibody, one (6%) for antimitochondrial and antinuclear antibody, and one (6%) for rheumatoid factor. Abnormalities of T or B lymphocytes in peripheral blood were detected in two (11%) relatives. Impairment of concanavalin A-induced lymphocyte transformation determined by ethidium bromide fluoroassay was found in seven (39%) relatives, although an abnormal response for phytohemagglutinin was detected in none of the relatives. The HLA haplotypes were not necessarily associated with positive autoantibodies or impaired concanavalin A-induced lymphocyte transformation in these families. These findings suggest that impairment of concanavalin A-inducible lymphocytes (mainly suppressor T cells) is one of the contributing factors in the development of PBC.

Adolescent

Sensitivity of polymerase chain reaction assay for Rickettsia tsutsugamushi in patients' blood samples.

We developed a nested polymerase chain reaction (PCR) method to detect Rickettsia tsutsugamushi (R. tsutsugamushi) DNA and determined its sensitivity. Primers were selected from the DNA sequence of the 58-kDa group-specific antigen gene of the Karp strain. The target sequence of rickettsial DNA was detectable as the band corresponding to 88 bp in 1.0 microgram of the DNA extracted from BS-C-1 cells infected with R. tsutsugamushi. Rickettsia-specific bands were observed not only for the homologous Karp strain, but also for four heterologous strains: two other reference strains (Gilliam and Kato) and two prototype strains prevalent in Miyazaki district (Irie and Hirano). The minimum copy number detectable by this method was estimated to be five rickettsiae. All of nine peripheral blood mononuclear cell samples from patients with tsutsugamushi disease who were seen 2-11 days after disease onset tested positive for rickettsial DNA. The PCR assay method presented here could be a specific diagnostic tool for tsutsugamushi disease, especially in its early acute stage.

Adult

Successful graft of HTLV-I-transformed human T-cells (MT-2) in severe combined immunodeficiency mice treated with anti-asialo GM-1 antibody.

To develop an experimental model of adult T-cell leukemia/lymphoma in small animals, severe combined immunodeficiency (SCID) mice treated with anti-asialo GM-1 antibody were inoculated with MT-2 cells, a cell line transformed by the human T-cell leukemia virus (HTLV-I). Three mice injected with 4 x 10(7) cells subcutaneously or intramuscularly developed tumors at or near inoculation sites. Immunofluorescent antibody (IFA) staining for HTLV-I structural protein, p19, revealed the specific antigen in the cytoplasm of most cells from tumors and the DNA signals of HTLV-I proviral DNA were also positive in cellular DNA by polymerase chain reaction assay with HTLV-I tax gene primers, SK43/SK44. The MT-2 cells did not invade in mouse organs.

Animals

[Progressing cases from low tone sudden deafness to Menière's disease--cochlear impairment in the so-called pre-Menière's disease period].

Among 80 patients with low tone sudden deafness (LTSD) who visited our department over the past 15 years, there were 6 cases (7.5%) who subsequently progressed to Menière's disease. The clinical and audiological processes of the 6 patients were studied in detail and the following results were obtained. (1) In these 6 patients, the time between onset of LTSD and the diagnosis of Menière's disease ranged from 4 months at the shortest to 6 years and 8 months at the longest, 2 years and 9 months on average. (2) Two pattern types were seen in the change from LTSD to Menière's disease: changing within a short period of time after recurrence of an LTSD-like attack, and changing after more than one year without recurrent attack. (3) The monoattack-nonrecovered type of LTSD and the recurrent type of LTSD within three months after the onset (short-term prognosis) frequently progressed to Menière's disease. (4) There were no close relationships between subjective symptoms and audiological features in the pre-Menière's disease period (from the onset of LTSD to the recurrence of vertigo with cochlear symptoms). (5) The 6 patients showed various audiogram shapes at the time of progression to Meniere's disease; 3 cases with the slightly rising type, 1 with the high frequency-impaired type, and 2 with the moderate, gradual and flat type. (6) Of the 6 patients, 3 had good hearing during long term observation. At least 2 patients seemed to have the mild type of Menière's disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Review of the evaluation criteria for low tone sudden deafness].

Low tone sudden deafness (LTSD) has the three following features; obscure origin, acute or sudden onset and sensorineural hearing loss limited to low frequencies without vertigo. Twenty LTSD patients with total hearing levels at low frequencies (125 Hz, 250 Hz, 500 Hz) from 70 dB to 95 dB (Group A) and 19 LTSD patients (typical LTSD) with levels above 100 dB (Group B) were studied. All patients visited our department within one week after onset. All presented over the past 3 years and were followed up for two years or more after initial examination. The clinical parameters such as incidence, subjective symptoms, the configuration of the audiogram and the prognoses of patients in the two groups were investigated comparatively. The following results were obtained. (1) Patients in their twenties were more frequently affected in group A, but patients aged 20 to 50 were equally affected in group B. (2) Females were more frequently affected in both groups, remarkably so in group B. (3) Hearing disorders frequently occurred after an upper respiratory tract infection and stress in both groups. (4) Fullness of the ear, tinnitus and hearing disturbance were common chief complaint and subjective symptoms in both groups. (5) The configuration of the audiogram seemed to be variable within each group and between the two groups. (6) The ratios of recurrent type to monoattack type were almost the same and the patients had good prognoses in both groups. From the results mentioned above, both groups were considered to belong to the same category of LTSD.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

[Study of tinnitus masking by self-recording audiometer].

The tinnitus masking test, in which the minimum masking levels of tinnitus by various pure tones and band noises are measured and used to produce tinnitus masking curves, is one of the methods for evaluating the character of tinnitus. At present, the tinnitus masking test is usually performed using a pure tone audiometer. In this study, tinnitus masking curves were produced using a self-recording audiometer (Bekesy audiometer) in 22 cases of tinnitus, and the basic nature of the tinnitus masking curves from the self-recording audiometer was investigated and compared with those from a pure tone audiometer. The results showed no changes in the masking level, and the amplitudes of the tinnitus masking curves from the self-recording audiometer were observed to be at the tinnitus pitches. The amplitude of the tinnitus masking curve showed a negative correlation with tinnitus loudness as measured by the loudness balance test for tinnitus, that is, the amplitude tended to decrease as the tinnitus became louder. This suggests that the loudness of the masking tone influences the tinnitus masking phenomenon.

Audiometry, Pure-Tone

Review of pharmacologic treatment of tinnitus.

Recent research on the pharmacologic treatment of tinnitus is reviewed, emphasizing studies in which controls have been used. Several double-blind cross-over studies have found that lidocaine can reduce tinnitus in about 50 to 75 percent of subjects. Unfortunately, it cannot be used clinically because it must be administered intravenously and its effects are very brief. Other drugs have been much less successful. A few controlled studies have found success rates between 33 and 56 percent using oxazepam, clonazepam, sodium amylobarbitone, flunarizine, and eperisone hydrochloride. None of these studies have been replicated, however. Closely controlled studies using specified etiologic subgroups with subjective and objective psychophysical measurements are needed.

Antidepressive Agents

Comparison of the properties of ribonucleases in human liver tissue and serum.

Two ribonucleases (RNases) with acidic pH optima were partially purified, one from normal human liver tissue and the other from serum. The properties of the two enzymes were studied and compared. Liver RNase was partially purified about 700-fold by acid fractionation, phosphocellulose column chromatography, Sephadex G-75 gel filtration, and polyguanylate affinity column chromatography. Serum RNase was purified about 1200-fold by phosphocellulose column chromatography and Sephadex G-75 gel filtration. The two RNases showed a similar optimal pH and molecular mass, and similar behaviour towards metal ions, but they differed in their substrate specificity. Liver RNase displayed a higher activity towards polyuridylate (poly(U)) than towards polycytidylate (poly(C)), while serum RNase hydrolysed poly(C) more rapidly than poly(U). These findings suggest that liver RNase is not the primary source of the serum RNase with an acidic pH optimum.

Cations

Exposure to hepatitis B virus in the general population of Hisayama, Japan: significance of isolated antibody to hepatitis B surface antigen in general population.

Cross-sectional survey on the prevalence of hepatitis B serological markers was performed in 2,411 residents who accounted for 74.4% of the population aged 40 and over and living in Hisayama Town, Japan, in 1983. Overall prevalences were 40.7% for both anti-HBs and anti-HBc, 6.1% for isolated anti-HBs and 5.4% for isolated anti-HBc. The condition with isolated anti-HBs was different from those with isolated anti-HBc and both anti-HBc and anti-HBs as follows. The titer of anti-HBs in isolated anti-HBs positive samples was significantly lower than that in both anti-HBs and anti-HBc positive ones (46.2 +/- 5.4 vs. 83.2 +/- 2.8, mean +/- SE, p less than 0.001). The presence of isolated anti-HBs was neither significantly more frequent in males nor related to the risk of liver damages in contrast with that of anti-HBc with or without anti-HBs. These findings suggest that isolated anti-HBs pattern with the absence of anti-HBc in general population was not due to prior HBV infection, but due to natural immunization with HBsAg.

Adult

Prevalences of hepatitis B surface antigen carriers and liver damages in the general population of Hisayama, Japan.

The prevalences of hepatitis B surface antigen (HBsAg) carriers and liver damages were studied in 2,411 residents aged 40 and over and living in Hisayama, Japan in 1983. Hepatitis B virus (HBV) associated markers were all measured by radioimmunoassay. HBsAg carriers were found in 2.3 per cent of the residents. Hepatitis B e antigen and antibody to hepatitis B e antigen were positive in 8.9 per cent and 80.4 per cent, respectively, of HBsAg carriers. The prevalences of liver damages in HBsAg carriers were compared with 1095 who had none of HBV markers (neither anti-HBc nor anti-HBs). The prevalences of abnormal aminotransferase level in sera were not different between HBsAg carriers and those who had none of HBV markers. A history of jaundice and/or hepatitis was evident in 32.3 per cent of male carriers and 24.0 per cent of female ones, being significantly more than those without HBV markers (13.1 per cent and 5.8 per cent, p less than 0.05 and p less than 0.005, respectively). These results indicate that, among HBsAg carriers aged 40 and over, few have active clinical signs of hepatitis, although about 20 per cent of them have histories of symptomatic hepatitis due to hepatitis B.

Adult

Marked reduction of cerebral oxygen metabolism in patients with advanced cirrhosis: a positron emission tomography study.

Regional cerebral blood flow (rCBF), cerebral metabolic rate of oxygen (rCMRO2), and oxygen extraction fraction (rOEF) were measured using positron emission tomography (PET) in four patients with cirrhosis (two males and two females, aged 57 to 69 years) in comparison with those in five age-matched controls with previous transient global amnesia. PET studies were carried out when the patients were fully alert and oriented after the episodes of encephalopathy. In the patients, rCBF tended to be lower, while rCMRO2 was significantly lowered in almost all hemisphere cortices, more markedly in the frontal cortex. Our results suggest that the brain oxygen metabolism is diffusely impaired in patients with advanced cirrhosis, and the frontal cortex seems to be more susceptible to the systemic metabolic derangements induced by chronic liver disease.

Aged

Acquired C1 inhibitor deficiency associated with systemic lupus erythematosus affecting the central nervous system.

A 22 year old woman with systemic lupus erythematosus affecting the central nervous system had acquired C1 inhibitor deficiency. She was admitted for treatment of psychotic behaviour, but showed no signs of angioedema. The serum complement profile of the patient showed normal C3 concentration and a depletion of C4, C2, C1 inhibitor, and C1q. Her parents had normal complement profiles. An extremely reduced C4 concentration may lead to involvement of the central nervous system in systemic lupus erythematosus.

Adult

Disseminated intravascular coagulation in a patient with progressive systemic sclerosis associated with necrotizing angiitis and generalized lymphadenopathy.

A 47-year-old woman with progressive systemic sclerosis developed disseminated intravascular coagulation in the course of her terminal illness. She also had complicating necrotizing angiitis and generalized lymphadenopathy. The likely relationship between disseminated intravascular coagulation and vasculitis is discussed.

Disseminated Intravascular Coagulation

Low activity of gamma-glutamyl transpeptidase in serum of acute intrahepatic cholestasis.

Low gamma-glutamyl transpeptidase (gamma-GTP) activity in serum was observed in 11 patients with acute intrahepatic cholestasis (cholestatic hepatitis and fulminant hepatitis), despite a marked increase in bilirubin levels. Inhibitors of gamma-GTP were not detected in sera of these patients. Their gamma-GTP levels in the liver were significantly higher than those in chronic liver diseases. An electrophoretic study of liver gamma-GTP in acute intrahepatic cholestasis showed the same mobility as in chronic liver diseases. These results suggest that the low serum gamma-GTP activity in acute intrahepatic cholestasis is due to factors inhibiting the release of the enzyme from the liver.

Alkaline Phosphatase

Pheochromocytoma with electrocardiographic change mimicking angina pectoris, and cyclic change in direct arterial pressure--a case report.

A forty-two-year-old man was admitted because of chest pain. Electrocardiograms at admission showed horizontal ST depression in leads, II, III, aVF, V4, V5, and V6. Direct blood pressure monitoring revealed cyclic change between 160/100 mmHg and 70/50 mmHg and heart rate between 80/sec and 120/sec at fifteen minute intervals. The plasma norepinephrine and epinephrine concentrations were elevated during the episodes of hypertension. Pheochromocytoma was found in the right adrenal gland. These cyclic changes in blood pressure and heart rate are an aid for diagnosis.

Adrenal Gland Neoplasms