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Biomedical subjects

M Osame

Publications and source records attributed to M Osame.

At least 397 records · Page 22Linked to original sources
PubMed1991

[Respiratory failure and its care in Duchenne muscular dystrophy].

Respiratory failure is the major cause of death in patients with Duchenne muscular dystrophy (DMD). In this report we retrospectively examined the clinical courses, pulmonary function, progression of scoliosis and the time of assisted ventilation. Forty nine patients, aged 2 to 27 years were studied and thirty eight patients of them were examined twice in some intervals. The subjects of examinations included pulmonary function studies consisting of spirometry, measurement of the thoracic scoliosis measured according to the method of Cobb and room air arterial blood gas values. The results were the following; 1) The decline in percentage values of vital capacity (%VC) began at age 8 or 9 and decreased consistently with age. Finally %VC reached under 10 percent at mean age of 21.53 with respiratory failure. 2) Thoracic scoliosis measured according to the method of Cobb increased further with advancing age. The greater the angle of curvature, the more likely the development of respiratory failure. 3) Sixteen patients received negative pressure ventilator (chest respirator: CR) between 16.5 and 25.1 years of age. Twelve patients used part-time (mainly night-time) ventilator and four patients used it in full-time. The average PaCO2 and PaO2 before administration of ventilator were 67.49 mmHg and 71.46 mmHg, respectively. The levels after ventilation were 58.01 mmHg (PaCO2) and 82.09 mmHg (PaO2).

Adolescent↗
PubMed1991

High levels of plant sterols and cholesterol precursors in cerebrotendinous xanthomatosis.

We measured the cholestanol, cholesterol precursor (lathosterol), and plant sterol (campesterol and sitosterol) concentrations of serum and bile in 11 patients with cerebrotendinous xanthomatosis. The mean values of serum cholestanol, lathosterol, campesterol, and sitosterol were, respectively, 8.4-, 2.5-, 2.7-, and 1.4-times higher in the patients than in normal control subjects (n = 26). Cholestanol (6.7-fold) and campesterol (3.7-fold) levels in bile (n = 4) were also elevated in the patients. There was no significant difference of serum sterol levels between patients with coronary artery disease and those without it. Chenodeoxycholic acid treatment for periods ranging from 6 months to 3 years and 4 months lowered serum lathosterol (57.7% reduction) and campesterol (57.8%) levels in parallel with cholestanol (70.8%) level, but the sitosterol level (19.7%) decreased less. Thus, increased levels of cholesterol precursor (lathosterol), plant sterols (campesterol and sitosterol), and cholestanol were found in the serum and bile in cerebrotendinous xanthomatosis. Chenodeoxycholic acid treatment effectively reduced the levels of these sterols, except for sitosterol.

Adult↗
PubMed1990

Constitutive expression of parathyroid hormone-related protein gene in human T cell leukemia virus type 1 (HTLV-1) carriers and adult T cell leukemia patients that can be trans-activated by HTLV-1 tax gene.

Adult T cell leukemia (ATL) is associated with human T cell leukemia virus type 1 (HTLV-1) infection, and almost all ATL patients have the complication of hypercalcemia. To understand the mechanism of the high incidence of hypercalcemia in ATL, we studied the expression of a parathyroid hormone-related protein (PTHrP) gene that has been proposed as a causative factor of hypercalcemia in some solid tumors. The polymerase chain reaction coupled with reverse transcription of mRNA was applied to RNA from peripheral blood mononuclear cells. Cells from all 13 ATL patients examined showed abundant expression of the PTHrP gene, while cells from uninfected normal subjects did not. Significant expression of PTHrP gene was also detected in HTLV-1 carriers without any symptoms and in patients with HTLV-1-associated myelopathy or tropical spastic paraparesis. PTHrP mRNA levels correlated with the number of infected cells that were estimated by the integrated HTLV-1 DNA. These results suggest that HTLV-1-infected cells are expressing the PTHrP gene. This concept was further supported by the finding that the HTLV-1 trans-activator, the tax gene product, caused trans-activation of the PTHrP gene promoter linked to the CAT gene. These observations might explain the general expression of the PTHrP gene in ATL patients and the high incidence of hypercalcemia in ATL.

Base Sequence↗
PubMed1990

Nationwide survey of HTLV-I-associated myelopathy in Japan: association with blood transfusion.

To study the epidemiology of human T-cell lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in Japan, we conducted two nationwide surveys between October 1986 and March 1989. A total of 710 patients with HAM (definite HAM, 589; probable HAM, 121) were reported. Of the 589 patients with definite HAM, 69% were residents of the areas with the highest prevalence HTLV-I in Japan. To determine the importance of blood transfusion in the pathogenesis of HAM/TSP, we performed a case-control study in the Kagoshima district in southern Japan. Significantly more patients with HAM reported a history of blood transfusion (26/129, or 20%) than did subjects in a health survey of the general population (41/1,290, or 3%; odds ratio = 7.7, p less than 0.001) or than did hospitalized neurological patients (6/119, or 5%; odds ratio = 4.8, p less than 0.001). Furthermore, the cumulative percentages of the intervals between blood transfusion and the onset of the symptoms of HAM fit a lognormal curve, suggesting that transfusion was an important common exposure. Blood transfusion probably transmitted HTLV-I to the patients with transfusion-associated HAM because there was a significant decrease in the number of patients with the transfusion-associated HAM who received blood after implementation of nationwide screening of blood donors in 1986 (p = 0.004). In the first 2 years, screening the blood supply in Japan appears to have decreased the number of reported patients with HAM by 16%.

Humans↗
PubMed1990

Association of a particular amino acid sequence of the HLA-DR beta 1 chain with HTLV-I-associated myelopathy.

Analyses of HLA-DRB1 gene using polymerase chain reaction and sequence-specific oligonucleotide probes reveal that the amino acid sequence Glu-Gln-Arg-Arg-Ala-Ala-Val at positions 69-75 of the third hypervariable region (HVR) of HLA-DR beta 1 chain is significantly associated with HTLV-I-associated myelopathy (HAM). Since the frequency of this sequence in HTLV-I carriers is almost the same as that in controls from Kagoshima (an endemic area of HTLV-I), this sequence may be related to susceptibility to HAM rather than to susceptibility to HTLV-I infection. Since this third HVR functions as putative antigen-binding sites and T cell recognition sites, the amino acid sequence of positions 68-73 was analyzed in detail. The analysis reveals that Gln70 and Arg71 are relevant to the occurrence of HAM.

Alleles↗
PubMed1990

An autopsied case of the Crow-Fukase syndrome: a neuropathological study with emphasis on spinal roots.

An autopsied case of the Crow-Fukase syndrome is reported. Neuropathological findings were as follows: (1) in the sural nerve, there was marked decrease of large and small myelinated fibers. Myelinated fibers showing axonal degeneration and segmental demyelination and remyelination were moderately increased. (2) In the lumbar spinal roots, myelinated fibers showing segmental demyelination and remyelination were frequently observed. The density of myelinated fibers of the ventral root was less at the dural site than the spinal site, while that of the dorsal roots was less at the spinal site than the dural site. (3) In the dorsal root ganglion, there were Nageotte's residual nodules and satelliotosis; (4) in the lumbar and thoracic spinal cord, there was pallor of the dorsal column; and (5) nerve cells showing central chromatolysis were frequently observed in the spinal anterior horn cells. Segmental demyelination and remyelination in the spinal roots and loss of myelinated fibers with axonal degeneration in the sural nerve are main neuropathological features of this syndrome.

Aged↗
PubMed1990

Elevated levels of interleukin-6 in serum and cerebrospinal fluid of HTLV-I-associated myelopathy/tropical spastic paraparesis.

A significant elevation of interleukin-6 (IL-6) level was observed both in serum (mean 0.455 +/- 0.251) and in cerebrospinal fluid (CSF) (mean 0.043 +/- 0.016) obtained from 13 patients with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) when compared to that of either asymptomatic carriers (mean 0.181 +/- 0.074 and 0.021 +/- 0.015, respectively) or controls (mean 0.208 +/- 0.119 and 0.021 +/- 0.015, respectively). The differences were statistically significant between HAM/TSP and asymptomatic carrier for serum (P less than 0.05) or CSF (P less than 0.01). The correlation indexes between serum IL-6 and anti-HTLV-I antibody titers in serum and CSF were 0.61 (P less than 0.06) and 0.67 (P less than 0.05), respectively. Both the cell count and protein level in CSF correlated with CSF IL-6 activity at 0.68 (P less than 0.01) and 0.56 (P less than 0.05), respectively. The results demonstrate that IL-6 may contribute to the production of anti-HTLV-I antibody, and signs of slight inflammation are present in the central nervous system in HAM/TSP.

Aged↗
PubMed1990

Arthritis in a human T lymphotropic virus type I (HTLV-I) carrier.

The case is described of a 57 year old woman with polyarthritis fulfilling the 1987 revised criteria of the American Rheumatism Association for rheumatoid arthritis, accompanied by clinical carrier state infection of HTLV-I. Anti-HTLV-I IgM antibodies were detected by western blot analysis in her synovial fluid and serum. Atypical lymphocytes with nuclear convolutions were found in synovial fluid and synovial tissue obtained from the affected knee joint, suggesting in situ activation of HTLV-I infected lymphocytes in the affected synovial compartment. The HTLV-I antigens were detected (1.2%) in short term cultured synovial fluid lymphocytes, by indirect immunofluorescence. These findings supported the possibility that HTLV-I has a role in triggering or modifying inflammation in the synovial compartment.

Arthritis, Rheumatoid↗
PubMed1990

Leucocyte alpha-1,4- and alpha-1,6-glucosidase activities towards oligosaccharides in late onset glycogenosis type II.

We describe the partial characterization and some properties of leucocyte alpha-glucosidase towards disaccharides with the alpha-1,4 (maltose) and alpha-1,6-glucosidic linkage (isomaltose) and tetrasaccharides with the alpha-1,4 (maltotetraose) and alpha-1,6-glucosidic linkage (tetrasaccharide, Glc alpha 1----6Glc alpha 1----4Glc alpha 1----4Glc, which was isolated from the urine of a patient with glycogenosis type II). Leucocyte alpha-glucosidase showed optimal activity towards all four oligosaccharides under two conditions, acidic (pH 4.0-4.5) and neutral (pH 6.0-6.5) regions. Our comparative studies on enzyme kinetics showed that leucocyte alpha-glucosidase was able to hydrolyze both the 1----4 isomers and the 1---6 isomers at acidic and neutral pH. Acid alpha-glucosidase could hydrolyze maltose about 10 times faster than isomaltose, and maltotetraose about 5 times faster than tetrasaccharide isolated from urine. In leucocytes of the patient with late onset glycogenosis type II, acid alpha-glucosidase activities towards maltose, isomaltose, maltotetraose and tetrasaccharide isolated from urine showed 75.3%, 67.4%, 76.5% and 41.4% of normal control values, respectively. Neutral alpha-glucosidase activities towards these four oligosaccharides were normal. Tetrasaccharide with alpha-1,6-glucosidic linkage might be accumulated by the impaired hydrolysis in the circulation as well as the leakage of undegraded glycogen to the circulation from the affected muscle.

Adult↗
PubMed1990

Autoproliferative and self-reactive T-cell lines from patients with HTLV-I-associated myelopathy.

In two patients with human T lymphotropic virus type 1 (HTLV-I)-associated myelopathy (HAM) and a non-HAM HTLV-I carrier, T-cell lines were generated and characterized from cerebrospinal fluid (CSF) lymphocytes and peripheral blood lymphocytes (PBL). In total, 62 T-cell lines were established using direct plating technique for expanding human T lymphocytes. Sixty three percent of the T-cell lines were CD4+, CDw29+ and HTLV-I gag+. CD8+T-cell lines were also established and they were gag-. Proliferation in the absence of additional antigens and exogenous interleukin 2 ("autoproliferation") was observed in 61% of the T-cell lines and significantly correlated with HTLV-I antigen (gag) expression. In addition, some T-cell lines from HAM patients exhibited proliferative response to self PBL, and the magnitude of their responses was diverse according to the phenotypes of stimulating cells. Therefore, the spontaneous lymphoproliferation observed in patients with HAM is generated by three components; HTLV-I-infected T cells and T cells reactive against HTLV-I and against self antigens. Since most gag+ T-cell lines produced lymphotoxin (LT)/tumor necrosis factor alpha (TNF alpha), it is suggested that those T cells are playing important roles in the pathogenesis of HAM.

Cell Line↗
PubMed1990

[Clinical and epidemiological studies on inpatients with dementia].

We have studied 97 patients with dementia who have been discharged from our hospital and 106 inpatients with dementia who have been admitted during last two years in our hospital. The diagnosis of dementia was done according to the criteria of DSM-III. Based on their clinical course, neurological signs, Hachinski's ischemic score and neuroradiological findings, we divided patients into 4 groups, [senile dementia of the Alzheimer type (SDAT), vascular dementia (VD), unclassified dementia and other dementias which includes dementia with Parkinson's disease or motor neuron disease, etc.]. Concerning 70 demented patients who died during hospitalization, the average age of onset and the duration of illness of SDAT were 80.5 years old and 4.6 years respectively and those of VD were 77.6 years old and 2.7 years respectively. The common causes of death were pneumonia (50%) and cardiac failure (24%). Recurrence of cerebral vascular accident (CVA) was also another frequent cause of death in VD. The most common behavioral problems causing admission in patients of SDAT were aimless wandering, nocturnal delirium, illusion and hallucination. In VD, nocturnal delirium, aimless wandering, violence and abnormal monologue were most common causes of admission. The important causes degrading ADL of inpatients were fracture, especially fracture of the hip joint, pneumonia, intestinal bleeding and CVA. Concerning the increase of the population of over 75 years old, it will be suggested that the care and treatment of demented patients in this age group will become a major social problem.

Aged↗
PubMed1990

[Clinical characteristics of anti-phospholipid antibodies].

Twenty-one patients with anti-phospholipid antibodies (APLA), who were selected from 104 patients with antinuclear antibody or anti-DNA antibody, were studied to define clinical characteristics of APLA. Of the 21 patients, the incidences of IgG anti-cardiolipin antibody (ACA), IgM ACA, lupus anticoagulant (LAC) and BFP-STS were 20, 7, 11 and 12, respectively, and they were highly related with each other. The number of items of the 1982 ARA revised criteria for the classification of SLE was significantly low (mean value = 3.3), and also the level of serum C 4 was significantly high (mean value = 88% of normal) compared with those in patients without APLA. The incidence of thrombocytopenia and hemolysis was significantly high when compared with those in patients without APLA, and they were closely related to the presence of LAC. The incidence of thrombosis was markedly high (48%), 10 of 21 patients, especially those of cerebral infarction and deep vein thrombosis. Cerebral infarction was significantly associated with LAC. The obstetric complication was 4 of 13 patients (31%) in the incidence, which was significantly high compared with that in patients without APLA. Of them, natural abortion was closely associated with LAC. Based on these observations, it seems that autoimmunological disease activity in patients with APLA may be slight to mild, and strongly suggested that APLA may play an important role particularly in the pathogenesis of acquired thrombotic tendency.

Adolescent↗