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Biomedical subjects

K Shinoda

Publications and source records attributed to K Shinoda.

At least 91 records · Page 5Linked to original sources
PubMed1995

Serial MRI in early Creutzfeldt-Jacob disease with a point mutation of prion protein at codon 180.

We report a 66-year-old woman with histologically diagnosed Creutzfeldt-Jacob disease (CJD), followed with MRI from an early clinical stage. MRI demonstrated expansion of the high cortical signal on T2-weighted images, which differs from previous MRI reports of CJD. This patient followed an atypical clinical course: 16 months had passed before she developed akinetic mutism, and periodic sharp waves had not been detected on EEG after 2 years in spite of her akinetic mutism. Brain biopsy showed primary spongiform changes in the grey matter, and a point mutation of the prion protein gene at codon 180 was discovered using polymerase chain reaction direct sequencing and Tth 111 I cutting. This is the first case with the point mutation of the codon 180 variant with an atypical clinical course and characteristic MRI findings.

Aged↗
PubMed1995

Electron microscopic finding of eccrine sweat gland epithelial cells in a patient with Krabbe disease.

A 13 month old boy was found to have severely reduced beta-galactocerebrosidase activity suggesting infantile Krabbe disease. Clinically, the patient showed a progressive neurological deterioration with white-matter disease on radiological study. Axillary skin biopsy was performed to support the diagnosis. On electron microscopy, needle-like inclusions, which are the typical finding seen in the cytoplasm of astrocytes and Schwann cells in the classic infantile form, were present in eccrine sweat gland epithelial cells. This method is useful for diagnosis when nerve biopsy and biochemical analysis are not readily available.

Eccrine Glands↗
PubMed1995

Lymphocytapheresis in combination with immunosuppressive drugs for refractory myasthenia gravis: two-color flow cytometric analysis of changes in peripheral blood lymphocyte subsets.

We carried out lymphocytapheresis (LCP) in combination with the administration of immunosuppressive drugs in patients with myasthenia gravis (MG), who were resistant to conventional immunosuppressive therapy, and examined its efficacy and effects on peripheral blood lymphocyte subsets. LCP was carried out once a week for 1 month (one course, 4 times) using a continuous-flow blood cell separator. Immunosuppressive medication (prednisolone or prednisolone and azathioprine) was continued during the course of treatment. After LCP, clinical improvement was noted in 5 of 6 patients. Anti-AChR antibody titers and the number of lymphocytes were significantly reduced in all patients. A significant decrease in CD4+CD45RA- (memory) T cell level and significant increase in CD4+CD45RA+ (naive) T cell level were also observed. In the patients having good response to LCP, follow-up evaluation showed long-term clinical improvements, as well as the memory T cell level staying at the decreased level. Our study suggests that LCP in combination with the administration of immunosuppressive drugs can suppress the disease activity of MG.

Autoantibodies↗
PubMed1995

Physical status and dementia risk: a three-year prospective study in urban Japan.

A three-year prospective study of 3,180 non-dementia persons in Sendai City, Japan was conducted to examine the effects of physical status and diseases diagnosed on dementia incidence. This cohort had been made at the initial survey in 1988 and the evaluation for incident dementia was performed on 2,461 respondents (77.4%) in a follow-up survey in 1991. Regarding physical status, the logistic regression including sex, age, health status, ambulatory activity and activities of daily living indicated that the poor health status and the limitation of ambulatory activity were significantly associated with an increased risk of dementia. The significant positive association with dementia was observed on stroke, respiratory disease and depression. This study identified the high risk population for dementia in the aspect of physical status.

Activities of Daily Living↗
PubMed1995

Multivariate analysis of limb long bone growth during the human prenatal period.

Prenatal development of the human limb bones (humerus, ulna, radius, femur, tibia, fibula) was studied. Cross-sectional data, consisting of 21 anthropometric measures of these bones were collected from 122 Japanese fetuses between the gestational ages of 18 and 40 weeks. Principal component analysis was applied to the data to provide multivariate assessments of morphological patterning among the variables. Three orthogonal components that accounted for 94.2% of the overall sample variation were extracted. The first component accounted for 88.2% of the variation and represented an axis of overall body size that was dependent on gestational age. The second and third components both reflected a trend in shape involving the cartilaginous parts of the humerus and femur. The findings indicated that different growth factors existed between the ossified and cartilaginous parts of fetal long bones. Multivariate allometric coefficients were extracted from the first principal component. The variables that were related to the construction of the articulate showed positive allometry, and the central widths of the diaphysis showed negative allometry compared with total size. In prenatal skeleton, certain shape changes are functionally linked to and required by changes in body size. A comparison among the coefficients of long bone length revealed that lower limb bones grew faster than upper limb bones during the period under study here. Allometric coefficients were equivalent among bones within a limb, whereas homologous bones in the upper and lower limb grew at different rates.

Bone and Bones↗
PubMed1995

Dementia and physical disability as competing risks for mortality in a community-based sample of the elderly Japanese.

To examine whether an excess mortality due to dementia is independent of coexisting physical disability, a probability-sample of the non-institutionalized elderly (n = 3,308) living in Sendai City, Japan was followed between 1988 and 1991. Of those, 128 were diagnosed as dementia in 1988 by psychiatrists, using Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised as a diagnostic standard. Information on the ability to perform activities of daily living (ADL) was collected by self-report of the study subjects in 1988 baseline survey. The survival status was investigated three years later. The risks of dementia and co-existing ADL disability for mortality was examined by Cox proportional hazard models. The results indicated that the relation between dementia and mortality was two-fold, depending upon the physical functions. Dementia increased the risk for mortality among those without ADL disability, but it did not so among those with ADL disability, rather ADL function was a stronger predictor for mortality among the latter individuals. Prevention and treatment of physical disability would be important for improving the survival of the demented people.

Aged↗
PubMed1995

Longitudinal study of serum and cerebrospinal fluid (CSF) class-specific antibodies against Campylobacter jejuni and GM1 ganglioside in Guillain-Barré syndrome.

We report two Guillain-Barré Syndrome (GBS) patients with culture-proven Campylobacter jejuni (Penner19/Lior 7). Elevated anti-C.jejuni IgA antibody declined to the normal range within one month, elevation of anti-C.jejuni IgM antibody lasted for 3 months and the titers of anti-C.jejuni IgG antibody were still elevated at one year after the neurologic onset. Serological criteria for antecedent C.jejuni infection in GBS patients should require 1) high titer of serum IgA and/or IgM antibody against C.jejuni followed by seroconversion of the IgA and/or IgM and 2) a 4-fold decline of IgG serum dilution against C.jejuni. Anti-C.jejuni antibodies in cerebrospinal fluid (CSF) reached the maximum value at one month after their neurologic onset which may not be responsible for the main pathological mechanism in the development of GBS. Anti-GM1 antibodies in serum and CSF were parallel with those of anti-C.jejuni antibodies during the course of the disease.

Adult↗
PubMed1995

Herpes simplex virus type 2 infections presenting as brainstem encephalitis and recurrent myelitis.

We describe here 3 patients with central nervous system infection caused by herpes simplex virus type 2 (HSV-2); one patient with brainstem encephalitis and two with recurrent transverse thoracic myelitis. All three patients showed increased IgG antibodies to HSV in the cerebrospinal fluid (CSF). HSV-2 DNA was demonstrated in the CSF by polymerase chain reaction (PCR) amplification. Upon treatment with acyclovir, one patient with myelitis partially recovered and the others completely recovered. It is important to recognize the wide spectrum of clinical manifestations of HSV-2 infection in the central nervous system (CNS).

Adult↗
PubMed1995

A case of osteoporosis with bilateral defects in the mandibular processes.

We carried out a detailed total body examination of a 62-year-old woman with osteoporosis who had bilateral defects in the mandibular processes. It was inferred that the defects in both articular heads were caused by resorption of small bone fragments following fracture. The quantity of bone salt was determined by microdensitometry, and a diagnosis of osteoporosis was then established. An improved bite was obtained by treatment consisting of tooth extraction and the preparation of partial dentures.

Absorptiometry, Photon↗
PubMed1995

RES-1214-1 and -2, novel non-peptidic endothelin type A receptor antagonists produced by Pestalotiopsis sp.

RES-1214-1 and -2, novel and non-peptidic endothelin antagonists, were isolated from the cultured broth of a fungus, Pestalotiopsis sp. RE-1214. RES-1214-1 and -2 selectivity inhibited the ET-1 binding to endothelin type A receptor (ETA receptor) with IC50 values of 1.5 microM and 10 microM, respectively. RES-1214-1 and -2 inhibited the increase in intracellular Ca2+ concentration elicited by 1 nM ET-1 in A10 cells. Taxonomy of producing strains, fermentation, isolation, structural determination, and biochemical properties of RES-1214-1 and-2 are described.

Animals↗
PubMed1995

[Giant cell interstitial pneumonia in a metal grinder with an abnormally high level of serum CA19-9].

Interstitial pneumonia and recurrent pneumothorax developed in a 48-year-old man who had worked as a metal grinder. He died of respiratory failure despite having received antibiotics and steroids, and despite having undergone pleural sclerosis therapy. Giant cell interstitial pneumonia was diagnosed; innumerable bizarre giant cells engulfing black granules were found within the alveoli. The results of high-energy dispersion X-ray microanalysis indicated that the patient had hard metal pneumoconiosis associated with tungsten in the black granules. When he was admitted to the hospital, his serum CA19-9 and SLEX concentrations were abnormally high (2600 and 200 ng/ml, respectively). Immunohistochemical analysis of lung tissue was done with anti-CA19-9 and SLEX antibodies. CA19-9 staining revealed strong bronchialization and squamous metaplasia in contrast to type II hyperplasia. SLEX staining showed strong type II hyperplasia. Further investigations will be needed to determine the mechanism of elevated tumor-associated carbohydrate antigens in serum.

Biomarkers, Tumor↗
PubMed1995

Clinical features of Japanese Leber's hereditary optic neuropathy with 11778 mutation of mitochondrial DNA.

The G to A transition of nucleotide position (nt) 11778 of mitochondrial DNA (mtDNA) has been frequently observed in Japanese Leber's hereditary optic neuropathy (LHON) cases. Therefore, we performed a multi-institutional study in Japan of LHON cases with this 11778 mutation of the mtDNA. Genetic and clinical data on 108 cases (90 affected and 18 carriers) in 79 unrelated families were obtained from 64 Japanese institutions. Detection of the nt11778 mutation was performed using restriction enzymes (74 cases) or dot blot with allele specific oligonucleotide (34 cases). Heteroplasmy was observed in 13 of the 90 affected cases and in 8 of the 18 carrier cases. Forty-five families had family history of LHON (44 maternal inheritance, 1 undetermined), and in 28 families (35.9%) there were isolated cases. The male-to-female ratio in the affected was 82:7 (92.1% male). The age at onset of visual loss ranged from 7 to 59 years (average: 23.4 years). All cases had bilateral involvement except one case with a blind eye resulting from ocular infection during childhood. Onset interval between the two eyes ranged from simultaneous to 17 months (average: 2.5 months), in 91.3% of cases being under 6 months. Visual acuity was 0.1 or worse in 152 (85.9%) of 177 eyes, only 6 eyes showing over 0.5. Progression of visual loss ranged from 0 to 48 months (average: 6.2 months). Central visual field abnormality was observed in 162 eyes (96.4%) of 168 eyes. Nonsuspect fundus in the ophthalmoscopic examination constituted 22.8% of eyes. Systemic corticosteroid was given to 45 (52.9%) of 85 cases and visual acuity was improved in only 2 cases (4.4%). Arrhythmia, neurological and muscular abnormality were observed as rare general complications. The present survey indicates that the male-to-female ratio is higher than the previous Japanese LHON statistics and that the visual outcome is better than in American LHON cases with the 11778 mutation.

Adolescent↗
PubMed1995

[Intracranial tuberculoma with spontaneous recovery].

A 57-year-old man was admitted because of headache, nausea, and fever up (38 degrees C). He showed nuchal rigidity slightly. CSF analysis showed 833 white blood cells (WBC) (80% monocyte), protein value of 68 mg/dl, glucose level of 36 mg/dl and ADA level of 11.8 IU/l. Brain pre-contrast CT indicated high density area in right parietal lobe, and it showed slightly homogeneously enhancement with contrast medium. MRI on T2 WI demonstrated hypointense lesion with bright central core in right parietal lobe. The lesion showed isointense on T1WI, and indicated homogeneous enhancement with Gd-DTPA. He was sent to our hospital after one week. With only antibiotics the symptoms were relieved and the CSF findings improved during the previous hospital. However, Mycobacterium tuberculosis (M. tuberculosis) DNA was detected in CSF by PCR amplification, and he recovered completely with anti-tuberculous treatment. This case was interesting to reveal atypical features of spontaneous recovery. Since Shankar's study using polymerase chain reaction (PCR) for detection of M. tuberculosis in cerebrospinal fluid (CSF), the PCR assay have been recognized to be a rapid method for diagnosis of tuberculous meningitis (TBM). But there are problems of PCR sensitivity when dealing with CSF samples containing small amount of M. tuberculosis DNA. Comparing direct PCR with nested PCR, we studied on the evaluation of PCR for diagnosis of TBM. In this study the nested PCR was positive in all CSF specimens from 4 patients with TBM, but we could not detect M. tuberculosis DNA by only the direct PCR. Nested PCR amplification improved the sensitivity and specificity.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Neuronal aromatase expression in preoptic, strial, and amygdaloid regions during late prenatal and early postnatal development in the rat.

Brain aromatase has been considered to be an important clue in elucidating the actions of androgen on brain sexual differentiation. Using highly specific anti-P450arom antiserum, the regional and subcellular distributions were immunohistochemically evaluated in the preoptic, strial, and amygdaloid regions of developing rat brains. Aromatase-immunoreactive (AROM-I) neurons were classified into three groups. The first, in which immunostaining occurs only during certain pre- or neonatal days (E16-P2), included the anterior medial preoptic nucleus, the periventricular preoptic nucleus, neurons associated with the strial part of the preoptic area, and the rostral portion of the medial preoptic nucleus. The second is a striking AROM-I cell group in the "medial preopticoamygdaloid neuronal arc," which extends from the medial preoptic nucleus to the principal nucleus of the bed nucleus of the stria terminalis and the posterodorsal part of the medial amygdaloid nucleus. The AROM-I neurons appeared by E16, reaching a peak in staining intensity between E18 and P2 and diminishing after the perinatal stage. After P14, a third group of AROM-I neurons emerged in the lateral septal nucleus, the oval nucleus of the bed nucleus of the stria terminalis, and the central amygdaloid nucleus. The second group was thought to be the major aromatization center in developing rat brains, while the center might partly shift to the third group of neurons after the late infantile stage. The distribution and developmental patterns were basically similar in males and females, suggesting that the neonatally prominent aromatase is not induced by male-specific androgen surges occurring around birth. On immunoelectron microscopy, subneuronal aromatase was predominantly localized on the nuclear membrane and endoplasmic reticulum, which appeared to be appropriate for the efficient conversion of androgen into estrogen just prior to binding to the nuclear receptors.

Amygdala↗
PubMed1994

Coexistence of the stigmoid body and estrogen receptor in some neuronal groups involved in rat reproductive functions.

Recent immunohistochemical studies have suggested that the forebrain distribution of stigmoid bodies, marked by an antibody against placental aromatase-associated antigen X-P2 (PAX), overlaps with that of the common binding sites of androgen and estrogen. In the present light- and electron-microscopy study the coexistence of stigmoid bodies and estrogen receptors (EsR) is immunohistochemically examined and quantitatively analyzed in the medial preoptic region, part of the bed nucleus of the stria terminalis and part of the medial amygdaloid nucleus of young female rats. Light microscopy with double immunostaining for PAX and EsR in all three regions indicates that 75-84% of the total of PAX-immunoreactive stigmoid structures are present in neurons which also contain EsR-immunoreactive nuclei, and that 75-78% of EsR-immunoreactive neurons contain PAX-immunoreactive inclusions. Electron microscopic analysis confirms that 70-80% of stigmoid body-containing neurons have EsR-immunoreactive nuclei. These results indicate that the majority of the stigmoid bodies and EsRs intimately coexist, strongly suggesting a functional interrelationship in brain regions which are involved in rat reproductive functions. Stigmoid bodies may play a role in subneuronal EsR mechanisms associated with aromatization in these sex steroid targets in rat brain.

Amygdala↗
PubMed1994

Sex-steroid receptor mechanism related to neuronal aromatase and the stigmoid body.

Recent immunohistochemical analyses of rat brains have established the presence of neuronal aromatase and stigmoid body in interfaces of a sex-steroid/brain axis. Aromatase P450-immunoreactive (AROM-I) neurons, which are present only during embryonic Day 16 to postnatal Day 2 (E16-P2), are found in the anterior medial preoptic nucleus, the periventricular preoptic nucleus, and the ventromedial hypothalamic nucleus. The largest AROM-I cell-group localized in the medial preoptico-amygdaloid neuronal arc (mPO-AM) shows a peak during E18-P2 and gradually diminishes after the perinatal days (but still retains the immunoreactivity in adults). In adults, other groups of AROM-I neurons emerge in the lateral septum, the central amygdaloid nucleus, and the bed nucleus of the stria terminalis. Male-predominant sex difference for aromatase expression has been detected at least in the young-to-adult mPO-AM, reflecting sexually distinct endocrine and behavioral responses in the rat reproductive functions. These results suggest the presence of distinct brain-aromatases with different regulatory systems. Neuronal aromatase may modulate development of sexual dimorphism in neonates and activation of reproductive functions in adults. The stigmoid bodies, marked by placental aromatase-associated antigen X-P2 (PAX) antiserum, are also frequent in the sex-steroid targets of rat brains and intimately coexist with estrogen receptors in the mPO-AM of young females. The neuronal inclusion, suspected as a RNA/protein conglomerate, appears to be induced by the decrease of androgen and/or the increase of estrogen, especially as a result of subneuronal aromatic switching into the estrogenous state. The neuronal aromatase and stigmoid body may play important roles in the pre- and post-receptor steps of subneuronal sex-steroids actions for brain sexual differentiation or induction of reproductive functions.

Amygdala↗
PubMed1994

The predictive power of self-rated health, activities of daily living, and ambulatory activity for cause-specific mortality among the elderly: a three-year follow-up in urban Japan.

OBJECTIVE: To examine the predictive power of self-rated health, activities of daily living (ADL), and ambulatory activity for different causes of death in a representative sample of older persons. DESIGN: Three-year prospective cohort study. SETTING: Sendai City, Japan. PARTICIPANTS: 2,552 persons 65 years and older at baseline in 1988. MEASUREMENTS: Independent variables (measured by self-report of participants) were age, sex, self-rated health, ADL, ambulatory activity level, and use of medical care. Dependent variables were mortalities from cancer, stroke, and heart disease. MAIN RESULTS: Self-rated health significantly predicted cancer mortality but not the other two causes of mortality. ADL disability was a significant predictor for stroke mortality, and limitation in ambulatory activity significantly increased the risk of heart disease mortality. The associations between ADL and stroke mortality as well as between ambulatory activity and heart disease mortality remained significant even after excluding those who reported having the index disease in 1988. CONCLUSION: The predictive powers of self-rated health, ADL function, and ambulatory activity varied significantly with the underlying causes of death among the elderly.

Activities of Daily Living↗