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Biomedical subjects

K Yamane

Publications and source records attributed to K Yamane.

At least 109 records · Page 6Linked to original sources

Neuroimaging findings of the development and resolution of solitary brainstem abscess: characteristics of neuroimagings in the early stage of brainstem abscess and importance of surgical management for brainstem abscess--case report.

A 64-year-old female presented with a solitary brainstem abscess. Magnetic resonance imaging and computed tomography demonstrated the development and resolution of the brainstem abscess with an unusual and fluctuating clinical course over several months. Serial neuroimaging examinations are required to detect a brainstem abscess in the early stage to establish the optimum treatment.

Brain Abscess↗

Antibody mimicking an anti-E antibody that binds to patient's E negative red cells.

We have reported a rare case of auto anti-E antibody with specificity mimicking alloantibody with E specificity. A patient whose red cells typed as R1R1 and who had a positive direct antiglobulin test was admitted to our hospital. After standard serologic testing was performed, flow cytometry, Western blot analysis and differential allogenic adsorption test were used to verify whether antibody binds to the patient's red cells and normal red cells. A high titer anti-E antibody was detected transiently from the patient's serum and eluate. An indirect antiglobulin test using red cells treated by cysteine-activated papain and dithiothreitol (ZZAP) and chloroquine showed that both the patient's serum and eluate bound an apparent anti-E antibody to E negative patient's red cells. Fluorescence activated cells sorter (FACS) and Western blot analysis verified that the patient's red cells lacked E antigen. Further, it was clarified that the antibody does not bind to any E negative normal red cells by differential allogenic adsorption test. These results provide evidence that an antibody mimicking an E alloantibody can bind to patient's own E negative red cells but not to allogenic E negative red cells.

Antibodies, Anti-Idiotypic↗

Detergent and antigen fragility affect the ELISA for measurement of anti-prothrombin autoantibodies.

OBJECTIVE: Some investigators have reported that anti-prothrombin autoantibodies (aPT) in lupus anticoagulant positive sera were detectable by ELISA. Discrepancies in aPT ELISA were observed by some investigators. To clarify this situation, we tested the binding of aPT positive sera to purified prothrombin under various conditions. METHODS: We performed aPT ELISA under different conditions. The variables we tested were: ELISA plate (untreated or gamma irradiated polystyrene plates), buffer (phosphate buffered saline or Tris buffered saline), detergent (presence or absence of Tween-20), and antigen condition (intact or fragmented prothrombin). RESULTS: Anti-PT from patients with lupus or antiphospholipid syndrome were similarly bound to prothrombin with both buffers. Addition of Tween-20 to the buffer increased reactivity in the irradiated plate assay, but decreased reactivity in the untreated plate assay. Reactivities in 90% of lupus sera were decreased by the use of fragmented prothrombin. In contrast, the reactivity of serum from a healthy subject was remarkably increased by antigen fragmentation. CONCLUSION: The discrepant ELISA results in measurement of aPT in the various reports may have been due to the use of detergent in the buffer and condition of the prothrombin used as antigen. In our experiments the best ELISA condition for measurement of aPT was achieved using buffer with Tween-20 detergent, with prothrombin directly coated onto irradiated polystyrene plates.

Antiphospholipid Syndrome↗

Dieulafoy's lesion of the esophagus as a probable complication of Takayasu's arteritis.

Dieulafoy's lesion is an abnormal submucosal artery in the gastrointestinal tract characterized by massive gastrointestinal bleeding. We describe a patient who developed Dieulafoy's lesion of the esophagus in the course of isolated pulmonary Takayasu's arteritis. Angiographic findings indicated a relationship between pulmonary arterial involvement of Takayasu's disease and Dieulafoy's lesion of the esophagus. This observation represents the first report of the association between Takayasu's arteritis and Dieulafoy's lesion of the esophagus.

Adult↗

Bacillus subtilis RNase III cleaves both 5'- and 3'-sites of the small cytoplasmic RNA precursor.

Bacillus subtilis small cytoplasmic RNA (scRNA) is a member of the signal recognition particle RNA family. It is transcribed as a 354-nucleotide primary transcript and processed to a 271-nucleotide mature scRNA. In the precursor, the 5'- and 3'-flanking regions form a stable double-stranded structure based on their complementary sequence. This structure is similar to those of substrates for the double-stranded RNA processing enzyme, RNase III. The B. subtilis enzyme that has similar activity to Escherichia coli RNase III has been purified and is designated Bs-RNase III. Recently, B. subtilis rncS has been shown to encode Bs-RNase III (Wang, W., and Bechhofer, D. H. (1997) J. Bacteriol. 179, 7379-7385). We show here that Bs-RNase III and the purified His-tagged product of rncS cleave pre-scRNA at both 5'- and 3'-sites to produce an intermediate scRNA (scRNA-275), although processing at the 3'-site is less efficient. The 5'-end of scRNA-275 was identical to that of the mature scRNA, whereas it contains four excess nucleotides at the 3'-end. Bs-RNase III cleavage yields a two-base 3'-overhang, which is consistent with the manner in which E. coli RNase III cleaves. We also show that truncation of the rncS gene affected processing, and significant amounts of an intermediate scRNA (scRNA-275) were found to accumulate in the rncS-truncated mutant. It is concluded that Bs-RNase III is an enzyme that processes pre-scRNA.

Bacillus subtilis↗

A newly developed shunt system for carotid surgery: T-shaped silicone shunt tubes and clamping devices: technical note.

BACKGROUND: Although the use of a shunt during carotid endarterectomy has been controversial, a convenient shunt system is still required. METHODS: We have devised an intraluminal shunt system, T-shaped silicone shunt tubes, and clamping devices for carotid surgery. The tube has enough pliability and length to be used in a looped or U-shaped mode and constructs a T-shape with a side arm available for monitoring blood pressure in the shunt system. Clamping devices, such as modified Sugita ring clips and encircle type bulldog clamps, make it possible to hold the tube by a simple maneuver and to minimize the intimal damage. RESULTS: This shunt system has been used in 170 carotid endarterectomies and other 10 carotid surgical operations, and the mortality and morbidity rates were 0% and 2.4%, respectively. CONCLUSION: This shunt system can be safely and easily used for cervical carotid surgery.

Brain Ischemia↗

Regulation and characterization of a newly deduced cell wall hydrolase gene (cwlJ) which affects germination of Bacillus subtilis spores.

The predicted amino acid sequence of Bacillus subtilis ycbQ (renamed cwlJ) exhibits high similarity to those of the deduced C-terminal catalytic domain of SleBs, the specific cortex-hydrolyzing enzyme of B. cereus and the deduced one of B. subtilis. We constructed a cwlJ::lacZ fusion in the B. subtilis chromosome. The beta-galactosidase activity and results of Northern hybridization and primer extension analyses of the cwlJ gene indicated that it is transcribed by EsigmaE RNA polymerase. cwlJ-deficient spores responded to both L-alanine and AGFK, the A580 values of spore suspensions decreased more slowly than in the case of the wild-type strain, and the mutant spores released less dipicolinic acid than did those of the wild-type strain during germination. However, the mutant spores released only slightly less hexosamine than did the wild-type spores. In contrast, B. subtilis sleB spores did not release hexosamine at a significant level. While cwlJ and sleB spores were able to germinate, CJSB (cwlJ sleB) spores could not germinate but exhibited initial germination reactions, e.g., partial decrease in A580 and slow release of dipicolinic acid. CJSB spores became slightly gray after 6 h in the germinant, but their refractility was much greater than that of sleB mutant spores. The roles of the sleB and cwlJ mutations in germination and spore maturation are also discussed.

Alanine↗

Effectiveness of superficial temporal artery-middle cerebral artery anastomosis in adult moyamoya disease: cerebral hemodynamics and clinical course in ischemic and hemorrhagic varieties.

BACKGROUND AND PURPOSE: The efficacy of superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in adult moyamoya disease was evaluated by clinicopathophysiological studies. METHODS: Fifteen patients with cerebral ischemic attacks (ischemia group) and 15 patients with intracranial hemorrhages (hemorrhage group) were investigated. Clinicoangiographic features and regional cerebral blood flow (rCBF) of the MCA territory were preoperatively and postoperatively investigated, and cortical arterial pressure (CAP) and anastomotic blood flow (AF) were intraoperatively measured. RESULTS: In the ischemia group, the preoperative rCBF of 38.4 mL/100 g per minute was significantly increased to 42.1 mL/100 g per minute with a diminution of angiographic moyamoya vessels in 67% of patients after surgery. The mean CAP and AF were 25.6 mm Hg and 34.7 mL/min, respectively. Proximal and distal cerebral vascular resistance (PCVR = [Mean Systemic Arterial Blood Pressure-Mean CAP]/rCBF and DCVR = [Mean CAP/rCBF]) were 1.78 and 0.68, respectively. One patient died perioperatively as a result of intracerebral hemorrhage. During follow-up (mean, 67 months), 12 of 14 patients recovered without neurological deficits, 1 was moderately disabled because of the initial insult, and another patient experienced an intracerebral hemorrhage but recovered fully. In the hemorrhage group, the preoperative rCBF of 38.0 mL/100 g per minute was significantly increased to 42.7 mL/100 g per minute with a diminution of moyamoya vessels in 60% after surgery. The mean CAP and AF were 29.1 mm Hg and 24.1 mL/min, respectively. PCVR and DCVR were 1.72 and 0.77, respectively. One patient became hemiparetic because of perioperative intracerebral hemorrhage. During follow-up (mean, 94 months), 3 patients had fatal intracranial hemorrhages, 10 had good recoveries, and 2 had moderate disabilities. CONCLUSIONS: This study revealed a high PCVR and a very low DCVR in both the ischemia and hemorrhage groups of patients. STA-MCA anastomosis partially normalized cerebral circulation and decreased moyamoya vessels but did not completely prevent rebleeding.

Adult↗

Familial amyotrophic lateral sclerosis with widespread vacuolation and hyaline inclusions.

This report presents a familial amyotrophic lateral sclerosis (FALS) patient with widespread vacuoles and hyaline inclusions strongly immunostained with the anti-superoxide dismutase (SOD1) antibody. The overall pathologic similarity between our non-SOD1-linked FALS patient and transgenic mice expressing a mutated human SOD1 gene suggests that common pathogenetic mechanisms other than an SOD1 mutation exist in the development of these diseases.

Aged↗

Subarachnoid hemorrhage caused by Aspergillus aneurysm as a complication of transcranial biopsy of an orbital apex lesion--case report.

A 62-year-old male complaining of unilateral visual disturbance and pain in the involved eye had a small mass at the right orbital apex which was identified as an Aspergillus granuloma by transcranial biopsy. One month later, the patient became comatose because of fatal subarachnoid hemorrhage due to a newly developed aneurysm. Autopsy showed a ruptured aneurysm on the right internal carotid-posterior communicating artery. Histological examination demonstrated prominent Aspergillus invasion of the arterial wall. Aspergillus infection must be taken into consideration in patients with orbital apex syndrome, which may lead to serious cerebrovascular consequences. If sino-orbital lesions are detected by neuroimaging techniques, biopsy using an extradural approach should be performed to obtain a definitive diagnosis.

Aneurysm, Infected↗

A delayed hemolytic transfusion reaction (DHTR) with multiple alloantibodies (Anti-E, Jka, Dia, Fyb, and S) induced by E-antigen-negative, crossmatch-compatible blood.

We describe the case of a 44-year-old woman with a delayed hemolytic transfusion reaction (DHTR). She had a history of two pregnancies and a blood transfusion, the details of which were unknown. At the time of her first vascular surgery on November 15, 1989, she received 1200 ml of crossmatch-compatible concentrated red blood cells (CRC). Before the first operation, screening for anti-RBC antibodies (Ab) was negative. At the time of the second admission on Feburary 15, 1996, anti-E Abs were detected by indirect antiglobulin test. She received 560 ml of E-antigen-negative, crossmatch-compatible, CRC for treatment of anemia on March 1 and 2, 1996. After this transfusion, total bilirubin (1.6 mg/dl) and lactate dehydrogenase (1355 IU/ml) were elevated on March 12, 1996. She had no evidence of clinical hemolysis. We suspected DHTR from these data, and therefore screened for anti-RBC Abs. Anti-E, Jka, Dia, Fyb, and S Abs were detected in blood samples obtained from the patient on March 12, 1996. Anti-E, Jka Dia, and S Abs were present more than 1 month and anti-Fyb Ab was disappeared at 18 days after transfusion.

Adult↗

[A case of cervical-mediastinal lymph node tuberculosis progressed to pulmonary lesion through a bronchial fistula].

The patient was a 25-year-old man who had been admitted to a local hospital due to fever and trachelophyma. Tubercle bacillus was detected in pus culture obtained by biopsy of the trachelophyma, but not in sputum culture. Because combined therapy with 3 antituberculous drugs (RFP, INH and SM) failed to reduce the fever or drainage from the biopsy region, the patient was transferred to our hospital. Chest X-ray films taken on admission revealed dilatation of the superior mediastinal shadow; chest CT images revealed cervical and mediastinal lymphadenopathy and an anterior mediastinal abscess, but no pulmonary lesion. About 2 months after admission, cough developed and Gaffky type 2 was detected in the patients sputum. Bronchoscopy and bronchography revealed a bronchomediastinal fistula. Forty days after the onset of cough, reticulogranular shadows were observed in the right upper lobe on chest X-ray films, and a diffuse centrilobular lesion was observed in the right upper lobe on chest CT images. From these clinical observations, the patient was given a diagnosis of cervical-mediastinal lymph node tuberculosis, which had progressed to pulmonary lesion through a bronchial fistula due to lymphadenitis.

Adult↗

Enhanced interleukin 6 production by cultured fibroblasts from patients with systemic sclerosis in response to platelet derived growth factor.

OBJECTIVE: The pathophysiology of systemic sclerosis (SSc) is poorly understood, but recent studies indicate the involvement of cytokines in the functional changes of SSc fibroblasts. We investigated interleukin 6 (IL-6) production by dermal fibroblasts from patients with SSc. METHODS: Fibroblast cultures were established from affected skin of patients with SSc and from skin of healthy controls. IL-6 in supernatants from cultured fibroblasts was measured using a specific IL-6 ELISA. RESULTS: SSc fibroblasts, starved in serum-free medium, produced only a small amount of IL-6. However, IL-6 production by SSc fibroblasts dramatically increased when the cells were cultured in serum-containing medium. Human whole blood serum was more effective than human platelet-poor plasma derived serum in the enhancement of IL-6 production by SSc fibroblasts. Platelet derived growth factor (PDGF)-AA and PDGF-BB, a major growth factor in serum, induced significant IL-6 production by SSc fibroblasts. In contrast, in normal fibroblasts, much less response to PDGF-BB and almost no response to PDGF-AA were observed. Expression of PDGF receptors on SSc fibroblasts was not significantly different from normal fibroblasts. However, IL-1 receptor antagonist (IL-1ra), when added in the medium, significantly inhibited the PDGF-induced IL-6 production by SSc fibroblasts. CONCLUSION: PDGF stimulates IL-6 production by SSc fibroblasts. The enhanced IL-6 production in response to PDGF is due in part to autocrine IL-1 of SSc fibroblasts. These abnormalities of fibroblasts may play an important role in the inflammatory and immunological processes of SSc.

Adult↗

[Effect of somatosensory disturbance to outcomes of motor function in thalamic hemorrhage: evaluation with short-latency somatosensory evoked potential (SSEP)].

We investigated the effect of the somatosensory functions to the outcomes of motor functions in 28 patients with thalamic hemorrhage. The disturbance of the pyramidal tracts was assessed by the destruction of the internal capsule found in computed tomography (CT). The disturbance of the somatosensory function was analyzed by the N20 component of short-latency somatosensory evoked potentials (SSEP). The outcomes of motor function was evaluated after 3 months of ictus. Correlations between the outcomes of motor function, disturbance of the pyramidal tract, and disturbance of the somatosensory function were discussed. The result indicated that functional outcomes statistically correlated with neither disturbance of the internal capsule alone nor disturbance of N20 alone. But, there was statistically significant between functional outcomes and the combination of disturbance of the internal capsule with disturbance of N20 (p < 0.05, Wilcoxon signed-rank). There was not statistical difference in hematoma volume or consciousness. The implications of these results suggest that somatosensory function may affect the recovery of motor functions.

Aged↗

[A mild case of acute eosinophilic pneumonia].

We encountered a mild case of acute eosinophilic pneumonia in a 24-year-old man who developed symptoms once he started smoking. Bronchoalveolar lavage revealed eosinophilia. Chest computed tomography revealed a small amount of bilateral pleural effusion and multicentric panacinar shadows with peripheral ground-glass opacities. During the clinical course, the patient suffered only cough and fever, which subsided in 13 days without the administration of steroids. Although the clinical course in this case resembled that of simple pulmonary eosinophilia, we diagnosed it as a mild case of acute eosinophilic pneumonia because pleural effusion rarely accompanies simple pulmonary eosinophilia, symptoms developed when the patient began smoking, and interstitial involvement was suggested by bilateral effusion and ground-glass opacity. We look forward to the establishment of the disease concept of acute eosinophilic pneumonia, including mild cases, and a classification system for eosinophilic lung diseases, including acute eosinophilic pneumonia.

Acute Disease↗

[Macroscopic and pathohistological investigation of endarterial plaque after intraoperative balloon dilatation of the carotid artery during carotid endarterectomy].

Twelve patients associated with stenosis of the extracranial carotid artery underwent intraluminal balloon dilatation during carotid endarterectomy (CEA). There were 11 men and 1 woman, and age ranged from 56 to 73 years old. The rate of stenosis, shown by angiography, in each patient was from 60 to 85% in width. After securing carotid blood flow by a T-shaped shunt tube, a balloon catheter was inserted from the exposed common carotid artery into the internal carotid artery. The balloon was inflated three or four times with 2.5-3.5 atm. for 30-40 seconds. Immediately after balloon dilatation, endoscopic investigation was performed (Wolf; hard type endoscope, 2.7 mm diameter). Then CEA was performed using the usual procedure. The removed endarterial plaque was investigated pathohistologically. In macroscopic and endoscopic findings, there were 6 patients with mural thrombosis, 4 patients with laceration of the intima, and one patient with outflow of atheroma from the intima. Only 3 patients had increase in lumen after balloon dilatation. In pathohistological appearance, all patients had a moderate degree of fibrosis, calcification, and atheroma in the cross section of the plaque. Ten patients had intramural hemorrhage. Three typical patients were revealed by the use of angiographical, ultrasonographical, endoscopic, and pathohistological presentation. Case 10 showed laceration of the intima by balloon dilatation, and had moderate increase in lumen size macroscopically and endoscopically. There were moderate cases of fibrosis, calcification, atheroma, and intramural hemorrhage. Dilatation of the lumen seemed to be accomplished by a decrease in thickness of the atheroma and intramural hemorrhage. Case 8 demonstrated an increase in lumen size, but also laceration of the intima and outflow of atheroma from the arterial wall. There were much atheroma and large intramural hemorrhage in the intima, which might become a source of enbolism. Case 7 revealed no laceration of the intima and no increase in lumen size. Preoperative ultrasonography showed hyperechoic finding and postoperative pathohistological findings showed severe fibrosis and calcification, which were thought to have interrupted balloon dilatation. There have been small numbers of reports about pathohistological presentation after percutaneous transluminal angioplasty (PTA), because it is very difficult to take a specimen after PTA. In this report we were able to present the necessity of preoperative investigations by angiography, ultrasonography, and 3D-CT.

Aged↗