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M Hashimoto

Publications and source records attributed to M Hashimoto.

At least 415 records · Page 23Linked to original sources

[Neuropsychiatric features in Dementia with Lewy bodies and Alzheimer's disease].

BACKGROUND AND PURPOSE: Dementia with Lewy bodies (DLB) is commonly accompanied by neuropsychiatric symptoms. Among them, visual hallucinations are reportedly distinguishing DLB from Alzheimer's disease (AD). However, studies that compared frequency of delusions or depression between in DLB and in AD demonstrated conflicting results. Other neuropsychiatric symptoms including aggression, anxiety, and disinhibition have been rarely explored in DLB. In the present study, in order to elucidate the distinctive neuropsychiatric features in DLB, we analyzed neuropsychiatric symptoms in patients with DLB and with AD using data-based materials. SUBJECTS AND METHODS: Subjects were 15 DLB patients extracted from the Dementia Data Bank in the Hyogo Institute for Aging Brain and Cognitive Disorders, where clinical information of patients with dementia were prospectively assembled with planed, standardized assessments. Both patients groups did not differ in age, education, and duration of illness. The male proportion was significantly greater in the DLB group compared with the AD group (DLB: Male 8, Female 7; AD: Male 27, Female 124, p = 0.008). Patients' neuropsychiatric symptoms were assessed with the Neuropsychiatric Inventory during an interview with a caregiver familiar to the patient's everyday behavior. The Mini-Mental State Examination (MMSE) was used for assessing severity of cognitive impairment. RESULTS: The DLB group had significantly lower MMSE scores compared with AD group (DLB: 16.2 +/- 5.6, AD: 19.3 +/- 4.4, p = 0.013). None of neuropsychiatric symptoms, however, showed a significant relationship with MMSE scores in the DLB group. Hallucination were present in eight (53.3%) of the DLB group. Visual hallucinations were present in seven patients, and both visual and auditory hallucinations in one patient. The frequency of hallucinations (p < 0.0001) and that of visual hallucinations (p < 0.0001) were significantly greater in the DLB group than in the AD group. There was no significant difference in the frequency of auditory hallucinations. Delusions were present in 11 (73.3%) of the DLB group. Misidentification delusions were present in 11 patients, and persecutory delusions were coexisted in 8 patients. The frequency of delusions and that of persecutory delusions in the DLB group did not significantly differ from the AD group. However, the frequency of misidentification delusions was significantly greater in the DLB group than in the AD group (p < 0.0001). No significant difference was noted in the frequency of other neuropsychiatric symptoms. CONCLUSIONS: Hallucinations, especially visual hallucinations, and misidentification delusions are helpful diagnostic features of DLB in differentiating from AD.

Alzheimer Disease↗

Hepatitis C viral genome in a subset of primary hepatic lymphomas.

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are not only hepatotropic but possibly hematotropic. Recent studies showed the presence of HBV in lymphoma cells of extrahepatic origin. In the current study, we examined the presence of HBV DNA and HCV RNA in the tumor tissues of nine patients with primary hepatic lymphoma (PHL). Immunohistochemical study using polyclonal anti-HCV antibody was possible in four cases. The age of the patients ranged from 45 to 78 years (median, 58 yr), with a male-to-female ratio of 2:1. A history of chronic hepatitis was found in three patients and of cirrhosis in one. Histologically, all of the cases were non-Hodgkin's lymphoma of B-cell phenotype, with a diffuse large cell type being the most common. Polymerase chain reaction using both the S and X region primers failed to detect HBV DNA in the lymphoma tissues. The HCV genome was detected by in situ hybridization in the tumor cells but not in the surrounding hepatocytes in the one case of cirrhosis, which probably resulted from a blood transfusion more than 20 years previous; immunohistochemical analysis revealed positive staining for anti-HCV antibody in the cytoplasm of lymphoma cells in this case. In two cases, positive signals were found only in the hepatocytes surrounding the lymphoma. This is the first report showing the presence of the HCV genome in the lymphoma cells of PHL. HCV could be involved in development of PHL directly or via exogenic antigenic stimulus from HCV-infected hepatocytes.

Aged↗

Renal AT1 receptor: computerized quantification in spontaneously hypertensive rats and DOCA-salt rats.

To assess the involvement of angiotensin II (Ang II) in the regulation of blood pressure, we investigated the alterations of renal Ang II type 1 (AT1) receptors in two different models of hypertension; i.e., in spontaneously hypertensive rats (SHR) and deoxycorticosterone acetate (DOCA)-salt hypertensive rats by using the method for quantification of in vitro macro-autoradiography (ARG). In the SHR model, although the number of cortical AT1 receptors equaled that of Wistar Kyoto (WKY) rats at 4 and 12 weeks of age, the number of medullary AT1 receptors in the 4-week-old SHR animals was significantly lower than that in age-matched WKY rats, and increased by 12 weeks of age. The renal AT1 receptor number in DOCA-salt hypertensive rats was significantly higher than that in control rats. The amount of these receptors also increased with age in both DOCA-salt hypertensive rats and control rats. These findings indicate that the development of medullary AT1 receptors in early stages of hypertension in the SHR model differs from that in WKY rats or DOCA-salt hypertensive rats. This suggests that renal AT1 receptors may contribute to the hypertension seen in the SHR group. The renal AT1 receptors appear to be up-regulated in early stages of DOCA-salt-induced hypertension as well.

Age Factors↗

[Intra-arterial preventive chemotherapy for residual liver after resection of hepatic metastasis from colorectal cancer].

We treated 18 cases with intra-hepatic arterial infusion chemotherapy after resection of hepatic metastasis from colorectal cancer (June 1991-September 1997). Eight cases were H1, 7 were H2, and 3 were H3. Hepatic lobectomy was done in 3 cases, lobectomy + partial resection in 2 cases, and partial resection in 13 cases. All cases received high-dose intermittent 5-FU infusion (WHF = 5-FU 1,000 mg/m2/5 hrs/w) on an outpatient basis. The total frequency of WHF was 4-54 times (average 29), and total 5-FU doses ranged from 6.0 to 81.0 g (average 40 g). The 1- and 5-year cumulative survival rates were 100% and 77.5% in all patients 100% and 87.5% in H1 group and 100% and 64.3% in H2 + H3 group, respectively. There was no significant difference of survival between the H1 and H1 + H3 groups. The 1- and 5-year recurrence rates in residual liver were 5.9% and 14.4%, respectively. One of 2 cases with residual liver recurrence was resected for metastasis again, and the patient is now in a disease-free state. WHF after resection of hepatic metastasis from colorectal cancer has a preventive effect for their survival, not only in H1 group but also in H2 + H3 group.

Antimetabolites, Antineoplastic↗

[Factors aggravating bronchial asthma in urban children (I)--The involvement of indoor air pollution].

The aggravation of bronchial asthma in today's urban child population was studied by an epidemiological study in order to elucidate the involvement of indoor air pollution in relation to housing style. The asthma group consisted of 210 children under 12 years old who had been recently diagnosed as having bronchial asthma and under the care of Osaka Prefectural Habikino Hospital. The non-asthma group consisted of 180 children under 12 years old who had been under care at Osaka Prefectural Hospital but had no present history of allergic symptom. The individual atmospheric environment and housing style were surveyed by questionnaire. Also, the amount of mite allergen (Dp: Dermatophagoides pteronyssinus, Df: Dermatophagoides farinae) in room and bedding dust and the concentration of cotinine in urine were examined as objective indicators for the load of environmental allergen and the indoor air pollution by tobacco smoke, respectively. In this study, bronchial asthma was classified into two types: atopic/non-atopic, according to whether Dp-specific immunoglobulin E (Dp-IgE) was present/absent (positive/negative). Thus, for the risk factors given above, their involvement in each type of asthma was examined by comparing the proportion of the exposed subjects between the three groups of atopic asthma, non-atopic asthma and non-asthma. As atopy is an important factor of child asthma, the relative risk (odds ratio) of Dp-IgE increase (atopy) was also determined for the same factors by logistic regression analysis in each of the asthma and non-asthma groups. The results are as follows: 1. Reinforced concrete housing material, which results in mal-ventilation, increased the load of indoor air pollutants such as tobacco smoke. 2. A higher amount of mite allergen in bedding dust increased Dp-IgE. 3. Heating with stove, which results in a higher room humidity as well as temperature, enhanced Dp proliferation and appeared to be involved in increasing the risk of atopic asthma. 4. Reinforced concrete housing material appeared to be involved in suppressing Dp-IgE and increasing the risk of non-atopic asthma. But some air pollutants such as tobacco smoke and mite allergen showed no relationship to these involvements.

Air Pollution, Indoor↗

[Factors aggravating bronchial asthma in urban children (II)--The involvement of atopy and serum fatty acids, and their interaction with urban living environment].

The aggravation of bronchial asthma in today's urban child population was studied by an epidemiological study in order to elucidate the involvement of food habits as well as individual factors such as age, sex, and history of atopic dermatitis, and the interaction with urban living environments. The asthma group consisted of 202 children under 12 years old who had been recently diagnosed as having bronchial asthma and under the care of Osaka Prefectural Habikino Hospital. The non-asthma group consisted of 81 children under 12 years old who had been under care at Osaka Prefectural Hospital but had no present history of allergic symptom. The individual factors and the urban living environments (atmospheric environment, housing style) were surveyed by questionnaire. Also, the mite (Dp: Dermatophagoides pteronyssinus, Df: Dermatophagoides farinae) specific immunoglobulin E (Dp-IgE, Df-IgE) and the composition of serum fatty acid were examined as objective indicators for atopy and dietary habits, respectively. In this study, bronchial asthma was classified into two types: atopic/non-atopic, according to whether Dp-IgE was present/absent (positive/negative). Thus, for the risk factors given above, their involvement in each type of asthma was examined. As atopy is an important factor of child asthma, the relative risk (odds ratio) of Dp-IgE increase (atopy) was also examined by logistic regression analysis in each of the asthma and non-asthma groups. The results are as follows: 1. As age increased, the risk of atopy increased but the risk of asthma decreased. 2. The risk of asthma increased as Dp-IgE rather than Df-IgE increased. 3. For the composition of serum fatty acid, the lower quartile ranking (LQR) group for a saturated fatty acid, stearic acid, and the upper quartile ranking (UQR) group for a mono-unsaturated fatty acid, oleic acid, had a higher risk of nonatopic asthma. 4. The LQR group for omega 6-poly-unsaturated fatty acid such as linoleic acid, had a lower risk of atopy. 5. The UQR group for a omega 3-poly-unsaturated fatty acid, eicosapentaenoic acid, had a higher risk of nonatopic asthma. The UQR of eicosapentaenoic acid and living environments within 25 m from a major road or housing of reinforced concrete structure showed involvement in synergistic increase in the risk of non-atopic asthma.

Asthma↗

[Study on abuse and neglect of the disabled elderly living at home].

To obtain basic information on elderly abuse and neglect in order to provide for its early discovery and prevention, a questionnaire survey about the present situation regarding abuse and neglect of the disabled elderly living at home was performed on health/medical service/welfare professions. Forty-two cases were analyzed. The major results were as follows; 1. Victims were 13 men and 29 women, approximately 1/3 of whom were in their 70's and another 1/3 in their 80's. Approximately 1/4 of the abusers were either sons or daughters of the victims. 2. Verbal abuse was the most frequent type of abuse with a rate of 69.0%. The percentage of psychological abuse was 61.9, passive neglect was 57.1%, active neglect was 50.0%, physical abuse was 47.6%, passive self-neglect was 28.6%, financial/material exploitation was 23.8%, active self-neglect was 16.7% and the others was 11.9%. The average number of abuse and neglect that an elderly received was 3.5. 3. The main causes of abuse and neglect did not appear to be simple but was complicated by related causes, many of both victims and abusers had elements in their personality, developmental history and interpersonal relationships that over a period of years formed the basis for the problematic behavior. Many abuse or neglect cases arose from caregiving burden of family caregivers or insufficient social systems for support to meet the needs of caring for the elderly. 4. The results suggest that for prevention and countermeasures for elderly abuse, there is an urgent need to arrange for expansion of health and welfare services to reduce burden of caregivers, provide for education of professionals of health/medical service/welfare for early discovery and proper handling of abuse problems, development of a checklist for early discovery, expansion of opportunities of improving care skill for family caregivers and establishment of consultation system for the elderly and caregivers, and organizing emergency shelter for victims of elderly abuse.

Aged↗

Changes in plasma and urinary norepinephrine following transdermal clonidine in spontaneously hypertensive rats.

To support a long-lasting antihypertensive effect of transdermal clonidine (CAS 4205-90-7), changes in plasma norepinephrine (NE) levels and urinary NE excretion as indices of the sympathetic nervous activities were investigated following transdermal and oral clonidine in conscious spontaneously hypertensive rats. Plasma NE levels were significantly reduced for 24 h during transdermal application of clonidine patch at 1.5 and 4.5 mg/kg on the back of each rat. Oral clonidine at 100 microgram/kg also lowered plasma NE levels. However, significant falls in the levels lasted only for 4 h after oral dosing. Urinary NE excretion was significantly decreased during both 4-8 and 8-24 h periods, and during an 8-24 h period following transdermal clonidine at 1.5 and 4.5 mg/kg, respectively. Significant decrease in urinary NE excretion was also produced during a 4-8 h period following oral clonidine at 100 micrograms/kg. Total urinary NE excretion during a 0-24 h period was dose-dependently reduced following transdermal clonidine, but was not altered following oral dosing. These findings suggest that the sympathoinhibitory effect of transdermal clonidine is more persistent than that of oral clonidine. Therefore, long-lasting antihypertensive effect of transdermal clonidine is closely associated with the sustained suppression of the sympathetic nervous activity.

Administration, Cutaneous↗

[Superior sagittal sinus thrombosis presenting with subarachnoid hemorrhage in a patient with aplastic anemia].

A 54-year-old female, who had been treated for aplastic anemia by metenolone acetate since 1981, developed a sudden unconsciousness in September 1995. On admission, she was drowny, CT showed a subarachnoid hemorrhage (SAH) in the right Sylvian fissure. Angiography demonstrated a complete occlusion of the superior sagittal sinus. The SAH was assumed to be originated from rupture of the right Sylvian vein, which was irregularly dilated on angiography. The dural sinus thrombosis was thought to be caused by a long term use of metenolone acetate, and it was discontinued. But her platelet count dropped due to the aggravation of aplastic anemia, and she developed repeated hemorrhagic infarction. An active anticoagulant therapy for the dural sinus thrombosis was thought to be inappropriate because she had the aplastic anemia and the hemorrhagic infarction recurred. We have successfully treated this case by mild anticoagulant therapy with nafamostat mesilate (Futhan).

Anemia, Aplastic↗

Abnormal distribution of the non-Abeta component of Alzheimer's disease amyloid precursor/alpha-synuclein in Lewy body disease as revealed by proteinase K and formic acid pretreatment.

The precursor of the non-Abeta component of Alzheimer's disease amyloid (NACP) (also known as alpha-synuclein) is a presynaptic terminal molecule that abnormally accumulates in the plaques of Alzheimer's disease (AD) and in the Lewy bodies (LBs) of Lewy body variant of AD, diffuse Lewy body disease, and Parkinson's disease. To better understand the distribution of NACP/alpha-synuclein and its fragments in the LB-bearing neurons and neurites, as well as to clarify the patterns of NACP/alpha-synuclein compartmentalization, we studied NACP/alpha-synuclein immunoreactivity using antibodies against the C-terminal, N-terminal, and NAC regions after Proteinase K and formic acid treatment in the cortex of patients with LBs. Furthermore, studies of the subcellular localization of NACP/alpha-synuclein within LB-bearing neurons were performed by immunogold electron microscopy. These studies showed that the N-terminal antibody immunolabeled the LBs and dystrophic neurites with great intensity and, to a lesser extent, the synapses. In contrast, the C-terminal antibody strongly labeled the synapses and, to a lesser extent, the LBs and dystrophic neurites. Whereas Proteinase K treatment enhanced NACP/alpha-synuclein immunoreactivity with the C-terminal antibody, it diminished the N-terminal NACP/alpha-synuclein immunoreactivity. Furthermore, formic acid enhanced LB and dystrophic neurite labeling with both the C- and N-terminal antibodies. In addition, whereas without pretreatment only slight anti-NAC immunoreactivity was found in the LBs, formic acid pretreatment revealed an extensive anti-NAC immunostaining of LBs, plaques, and glial cells. Ultrastructural analysis revealed that NACP/alpha-synuclein immunoreactivity was diffusely distributed within the amorphous electrodense material in the LBs and as small clusters in the filaments of LBs and neurites. These results support the view that aggregated NACP/alpha-synuclein might play an important role in the pathogenesis of disorders associated with LBs.

Cadaver↗

Cerebral glucose metabolism in patients with frontotemporal dementia.

UNLABELLED: Frontotemporal dementia (FTD) is a dementia syndrome characterized by peculiar behavioral changes arising from frontotemporal involvement and distinct from Alzheimer's disease (AD). The purpose of this study was to elucidate the specific patterns in cerebral glucose metabolism in patients with FTD and to compare them with the patterns in patients with AD and normal elderly subjects using fluorodeoxyglucose (FDG) and PET. METHODS: Twenty-one patients with a clinical diagnosis of FTD [mean age 67.0 +/- 7.0 yr, Mini Mental State Examination (MMSE) score 18.7 +/- 5.7], 21 age-, sex- and dementia-severity-matched patients with probable AD (mean age 66.9 +/- 7.1 yr, MMSE score 20.2 +/- 5.5) and 21 age- and sex-matched normal control subjects (mean age 66.8 +/- 5.7 yr) were studied. The cerebral metabolic rate for glucose (CMRglc) was measured with FDG and PET. Absolute measures of regional CMRglc were compared among the three groups. One-way ANOVA and the posthoc Tukey HSD test were used for statistical analyses. RESULTS: In the FTD group, CMRglc was preserved only in the left cerebellum, right sensorimotor area and occipital lobes. The CMRglc was significantly lower in the FTD group as opposed to the AD group in the hippocampi, orbital gyri, anterior temporal lobes, anterior cingulate gyri, basal ganglia, thalami, middle and superior frontal gyri and left inferior frontal gyrus. CONCLUSION: Although metabolic abnormality in FTD is predominant in the frontal and anterior temporal lobes and the subcortical structures, it is more widespread than has been previously stressed. These findings document an FTD-specific cerebral involvement and facilitate differential diagnosis of degenerative dementias.

Aged↗

[A case report of selective IgA deficiency in rheumatoid arthritis and anti-IgA antibody induced anaphylactic transfusion].

We described a case of rheumatoid arthritis (RA) with selective IgA deficiency. A 69 year-old female with RA was admitted because of gall bladder cancer, and also had selective IgA deficiency which serum IgA level was less than 5.0 mg/dl, and IgA 1 and IgA 2 subclasses were not detected. Prior to the operation, she was given red cell compatible blood transfusion because of severe anemia. After 30 min of transfusion, she developed chill, nausea, vomiting and hypotension. These anaphylactic reactions might be induced by the presence of anti-IgA antibody, since the level of this antibody titers in her serum was elevated, assessed by the methods of ELISA and Western blotting. Although a case of RA associated with selective IgA deficiency, and also with elevated serum anti-IgA antibody level is extremely uncommon, attention should be paid to the presence of anti-IgA antibody in patients with selective IgA deficiency to avoid any unexpected anaphylactic reactions.

Aged↗

Nitrogen dioxide modifies allergic inflammation in tracheal mucosa.

Our study was designed to investigate the possible role of nitrogen dioxide exposure in respiratory allergic disorders. Guinea pigs were treated with a combination of passive sensitization, antigen challenge and nitrogen dioxide exposure. Nitrogen dioxide accumulated eosinophils to the epithelium of the trachea. Neither passive sensitization nor antigen challenge with nitrogen dioxide exposure developed more prominent pathological changes than nitrogen dioxide exposure alone. However, antigen--antibody interaction with nitrogen dioxide exposure resulted in a disruption of epithelial cells so prominent that the basement membrane was denuded in areas. Activated eosinophils and free eosinophil-specific granules were considered to be responsible for the extreme epithelial injury. In conclusion, nitrogen dioxide exposure does not cause prominent epithelial injury by itself, but could be a trigger for hyperresponsiveness in allergic airways, and is probably involved in the pathogenesis of airway allergic disorders.

Air Pollutants↗

Treatment of cirrhotic rats with epidermal growth factor and insulin accelerates liver DNA synthesis after partial hepatectomy.

Prevention of postoperative hepatic failure is important after hepatic resection. In patients with cirrhosis, impaired liver function and regenerative capacity after major hepatic resection are associated with increased morbidity and mortality. In this study, a combination of epidermal growth factor (EGF) and insulin were used as hepatotrophic factors in an attempt to stimulate DNA synthesis after 70% hepatectomy (HTX). Regenerative capacity was evaluated in normal and cirrhotic rat liver by measuring DNA synthesis in vivo. Micronodular liver cirrhosis was established by the simultaneous oral administration of CCl4 and phenobarbital. Epidermal growth factor plus insulin was injected subcutaneously immediately after and 12 h after HTX or sham operation was performed. Rats were killed 24 h after the operation and liver regeneration was estimated by [3H]-thymidine incorporation into DNA as well as an autoradiographic nuclear labelling index. Hepatectomy increased [3H]-thymidine incorporation significantly in both normal and cirrhotic rats. In cirrhotic rats, [3H]-thymidine incorporation after HTX was significantly lower than in normal rats and administration of a combination of EGF and insulin after HTX enhanced [3H]-thymidine incorporation. In conclusion, DNA synthesis 24 h after HTX is decreased in cirrhotic rats compared with normal rats and EGF supplementation with insulin accelerates DNA synthesis in hepatectomized cirrhotic rats. The data suggest that administration of combinations of exogenous hepatotrophic factors may play a useful role in the treatment of cirrhotic patients undergoing major hepatic resection.

Animals↗

Down regulation of a harmful variant protein by replacement of its normal protein.

To compensate for the hypoprotein and hypoalbuminemia of familial amyloidotic polyneuropathy (FAP) patients, 800 ml of fresh frozen plasma (FFP) was intravenously administered and change in total and variant transthyretin (TTR) levels were measured in the plasma. After injection of FFP, total plasma TTR levels were elevated and variant TTR levels decreased from 24 to 48 h, accompanied by an elevation of plasma total protein, albumin levels and TTR levels. To elucidate the mechanism of this phenomenon, a large amount of purified normal TTR from normal human plasma was intravenously injected in mice and FAP patients. By intravenous injection of 3 mg of the purified TTR to C57Black6, the expression of TTR mRNA decreased from 6 to 24 h post injection, and gradually increased up to 48 h post injection. After injecting 400 mg of normal TTR in each of 3 FAP patients, total plasma TTR levels were elevated and variant TTR levels decreased significantly from 24 to 48 h. These results suggested that down regulation of the harmful protein by replacement of its normal form of the protein occurred by this method. This phenomenon should be applied as the basis for one of the useful methods for decreasing the harmful proteins in the circulation.

Adult↗