Biomedical subjects
Publications and source records attributed to M Miyata.
A 25-year-old Japanese woman had both ulcerative colitis and Takayasu's disease and was positive for HLA-A24, BW52, and DR2. She was found to have thickening of the wall of the carotid artery on contrast-enhanced computerized tomography of the neck and chest. Prednisolone, beraprost, and sulfapyridine achieved rapid remission of both diseases.
A 14-year-old female with ulcerative colitis developed right anterior cervical pain and high fever. Cervical contrast-enhanced computed tomography (CE-CT) showed a wall thickness of the right common carotid artery which suggested aortitis. Her pulmonary angiography demonstrated a narrowing of the pulmonary arteries and she was diagnosed as having Takayasu's disease associated with ulcerative colitis. HLA analysis showed Bw52 and DR2 haplotype, which is frequently found in patients with Takayasu's disease associated with ulcerative colitis.
We studied the difference in the proportion of fast and slow myosin subunits in axially subdivided external urethral sphincter of male rabbit using myosin light chain and heavy chain analyses. The whole urethras from 6 adult male Japanese White rabbits were sagittally bisected and one halves from all animals were processed for myosin light chain analysis and another halves from all animals for myosin heavy chain analysis. Each half urethra containing the external urethral sphincter was subdivided into 4 parts, namely prostatic (P), prostatic apical (PA), infraprostatic (IP) and bullbourethral glandular (BUG) portions, from cranial to caudal direction. The electrophoretic samples from 4 different parts were separately processed. The external urethral sphincter muscle in each part from all animals were processed together for a sample because of the minute amount of the muscle. Two-dimensional electrophoresis according to the procedure of O'Farrell for myosin light chains and SDS-polyacrylamide gel electrophoresis containing 40% glycerol for myosin heavy chains were carried out. Molar ratio of myosin subunits were estimated by the dye elution procedure. The relative proportions of slow myosin molecules in respective parts were 33.4% (P), 26.3% (PA), 18.5% (IP) and 11.0% (BUG) from myosin light chain analysis and 20.3% (P), 16.1% (PA), 7.2% (IP) and 5.0% (BUG) from myosin heavy chain analysis. The urethral striated musculature in male rabbit was predominantly composed of fast myosin subunits as a whole. But the proportion of slow myosin subunits occupied a relatively high percentage in the proximal region and tended to decrease toward the distal end.(ABSTRACT TRUNCATED AT 250 WORDS)
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We experienced three patients who have collagen diseases with respiratory failure accompanied by hyponatremia. They were one systemic lupus erythematosus patient with interstitial pneumonia, one rheumatoid arthritis patient with acute pneumonitis, and one dermatomyositis patient with pulmonary fibrosis and organizing pneumonia. In all 3 patients, hyponatremia appeared along with a decrease in arterial O2 partial pressure (PaO2) and the hyponatremia tended to improve when the PaO2 increased after inhalation of oxygen, even though their respiratory failure were not improved. In dermatomyositis patient, serum Na levels were over-corrected after increase in PaO2. The serum and urine osmolality, serum antidiuretic hormone (ADH) levels and clinical pictures demonstrated a presence of inappropriate secretion of ADH (SIADH) in all 3 cases when hyponatremia and hypoxia appeared. A close association between hyponatremia and hypoxia observed in 3 patients strongly suggested that their SIADH were associated with hypoxia since SIADH could be demonstrated by hypoxia. Therefore, it is important to realize that hypoxia-induced hyponatremia will be promptly corrected to hypernatremia by an oxygen inhalation, which could cause a lethal central pontine myelinolysis.
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A 61-year-old male who had been regularly hemodialyzed for a year and 8 months developed a double-loculated chronic subdural hematoma (CSDH). Computed tomography (CT) revealed a heterogenous-density hematoma at the right fronto-parietal convexity. After a burr hole aspiration and irrigation, CT disclosed a residual hematoma and a septum separating the hematoma cavities. The hematoma and the septum were removed by right frontal craniotomy. At surgery, it was found that the thick septum completely separated the hematoma cavities and the outside hematoma was made up of coagula containing trabecula-like structures, and the inside hematoma consisted of old bloody fluid. Histological examination showed that the outer membrane and the septum were both thick because of the invasion by numerous lymphocytes which suggested that the intramembraneous bleeding from sinusoids split the outer membrane of an old CSDH. Double or multi-loculated CSDH should be considered in a case which is slow in recovery or aggravated after a burr hole aspiration and irrigation.
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A 60-year-old man who had a partial gastrectomy for gastric cancer 10 years ago was referred to our hospital for further examination for liver tumor. He was diagnosed as leiomyosarcoma of residual stomach associated with liver metastases. After preoperative transarterial embolization (TAE) with epirubicin of the anterior branch of right hepatic artery, residual stomach was resected, and the reservoir catheter and infusion arterial port were implanted. He was treated by intra-hepato-arterial chemotherapy of epirubicin. The patient has remained well for 2 years and 3 months without apparent complications.
OBJECTIVE: The proliferative response of mononuclear cells (MNC) in synovial fluid (SF) and peripheral blood (PB) of patients with rheumatoid arthritis (RA) to mycobacterial 65 kDa heat shock protein (HSP65) was tested and the response compared with the percentage of HLA-DR+.gamma delta+ T cells in lymphocytes of SFMNC or PBMNC: METHODS: Proliferative response of MNC was measured by means of 3H-thymidine incorporation and expressed by means of the stimulation index. Percentage of HLA-DR+.gamma delta+ T cells in lymphocytes was measured by means of the 2-color flow cytometry method. RESULTS: Higher response of SFMNC than PBMNC to HSP65 was noted in 14 of 19 patients with RA. Stimulation indexes of RA-SFMNC correlated significantly with HLA-DR+.gamma delta+ T cell percentage in lymphocytes. CONCLUSION: In the SF of patients with RA, an accumulation of HSP65 reactive and HLA-DR+.gamma delta+ T cells was noted.
A case of Henoch-Schönlein purpura with chronic thyroiditis associated with pregnancy is reported. A 27-year-old woman had a struma since age 14. She felt easily fatigable along with enlargement of the struma after the delivery of her first child, and was diagnosed as having chronic thyroiditis. She developed hematuria between the first delivery and the second pregnancy. The hematuria continued during the second pregnancy and in the postpartum period. Immediately after the delivery of her second child, she developed purpura followed by arthralgia and melena. Renal biopsy revealed focal segmental and global type Henoch-Schönlein nephritis. We reviewed five cases of Henoch-Schönlein purpura associated with pregnancy and found that our case is the first in which purpura developed immediately after delivery. Our patient would have developed Henoch-Schönlein nephritis between the first delivery and the second pregnancy. She developed Henoch-Schönlein purpura possibly due to rebound activation of immune response in the postpartum period after the disappearance of dramatic suppression of both humoral and cell-mediated immunity in the pregnant period.
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