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Biomedical subjects

N Fukuhara

Publications and source records attributed to N Fukuhara.

At least 37 records · Page 2Linked to original sources

Gene locus for autosomal recessive distal myopathy with rimmed vacuoles maps to chromosome 9.

Distal myopathy with rimmed vacuoles is an autosomal recessive muscular disorder, characterized clinically by weakness of the distal muscles in the lower limbs in early adulthood. Recently, the gene locus for familial vacuolar myopathy with autosomal recessive inheritance (hereditary inclusion body myopathy) was mapped to chromosome 9 by genome-wide linkage analysis of nine Persian-Jewish families. Since both disease conditions share similar clinical, genetic, and histopathological features, we analyzed seven families with distal myopathy with rimmed vacuoles using ten microsatellite markers within the region of the hereditary inclusion body myopathy locus. Significantly high cumulative pairwise lod scores were obtained with three markers: D9S248 (Z(max) = 5.90 at theta = 0), D9S43 (Z(max) = 5.25 at theta = 0), and D9S50 (Z(max) = 4.23 at theta = 0). Detection of obligate recombination events as well as multipoint linkage analysis revealed that the most likely location of the distal myopathy with rimmed vacuoles gene is in a 23.3-cM interval defined by D9S319 and D9S276 on chromosome 9. The results raise the possibility that distal myopathy with rimmed vacuoles and hereditary inclusion body myopathy in Persian Jews are allelic diseases.

Adult↗

[Clinical evaluation of intra-arterial infusion chemotherapy for advanced or recurrent cervical cancer with or without radiotherapy].

We analyzed 52 cases of advanced or recurrent cancer of the cervix treated by intra-arterial infusion chemotherapy (IAIC) with or without radiotherapy. IAIC regimen was separated into two groups: Group I consisted of 5-FU + MMC +/- ADR (30 cases) and group II of CDDP + MMC +/- 5-FU (22 cases). The tip of the catheter was placed in the bifurcation of abdominal aorta or the bilateral internal iliac arteries (7 cases). The overall response rate (CR + PR) was 71%, 87% in patients given radiotherapy, 50% in those without radiotherapy, and 100% in primary cases. The five-year survival rate was 20% in primary cases, 14% in recurrent cases, 3% in Group I and 38% in Group II (p = 0.00182) by chemotherapy regimen. Severe (more than grade III) hematological acute side effect was 48% for all cases, but recovered by interruption of drugs. In 7 cases in which the tip of the catheter was placed in internal iliac arteries, there were severe skin ulcers in 2 cases and severe pain of leg or gluteal region requiring narcotics in 2 cases. These data suggest that IAIC mainly with cisplatin with or without radiotherapy is one of the effective treatments for advanced or recurrent cervix cancer. But we should check the blood flow distribution periodically, and control the concentration of drugs.

Adenocarcinoma↗

Quantitative study of intermediolateral column cell counts in Machado-Joseph disease.

The number of intermediolateral column (ILC) neurons in 6 alternating segments from the 2nd to 12th thoracic segment of the spinal cord were studied in 4 cases with Machado-Joseph disease (MJD), 3 cases with olivopontocerebellar atrophy (OPCA), a case with Shy-Drager syndrome (SDS), and 5 normal controls. We counted the number of ILC neurons with clearly defined nucleoli in 12 sections of each segment, each section 20 microns thick and taken at 100 microns intervals and then divided the 6 alternating segments into 3 groups, upper (Th2, 4), middle (Th6, 8) and lower (Th10, 12). In each of the three groups of normal control cases, the number of ILC neurons had decreased with aging. In all MJD cases, the number of ILC neurons had moderately decreased in comparison with age-matched controls. One of the MJD cases showed a marked decrease in the number of ILC neurons, as did the SDS case. The ILCs of the entire thoracic spinal cord in the MJD cases were moderately involved.

Aged↗

[Tuberculous aneurysm of the descending aorta--successful surgical treatment].

A 62-year-old woman visited her primary physician because of high fever and vomiting. From a chest roentgenogram miliary tuberculosis was diagnosed. Anti-tuberculosis drugs were prescribed. Mycobacterium tuberculosis was cultured from samples of sputum. Although she took drugs for 3 months, her symptoms did not resolve and back pain developed. A chest roentgenogram showed an egg-sized mass in the posterior part of the mediastinum. Examination of a chest CT scan showed that the mass was an aortic aneurysm. A graft replacement was done, and histologic examination of the resected specimen showed that it was a tuberculous aneurysm of the descending aorta. Her symptoms disappeared, and she recovered fully. Tuberculous aneurysms are rare: they account for only 0.3% of all aneurysms. This is only the 9th reported case of tuberculous aneurysm successfully treated with surgery in Japan. We must realize that aneurysms are life-threatening complication of miliary tuberculosis.

Aortic Aneurysm, Thoracic↗

[Successful treatment of pulmonary alveolar proteinosis by massive bronchoalveolar lavage].

In two patients with pulmonary alveolar proteinosis, PaO2 was normalized by massive bronchoalveolar lavage (BAL). Patient 1: A 29-year-old man presented with exertional dyspnea and a PaO2 of 57.8 mmHg. After four BALs, the PaO2 was 106.4 mmHg. For ten years thereafter he has been doing well. Patient 2: A 58-year-old women presented with extertional dyspnea and a PaO2 of 64.4 mmHg. The PaO2 increased to 110.6 mmHg after four BALs. BAL required much skill, but it is one of the most effective methods for the treatment of pulmonary alveolar proteinosis. Because this condition is related to an interstitial process, these two patients need to be followed carefully.

Adult↗

[Clinical evaluation of intra-arterial infusion chemotherapy for advanced or recurrent pelvic tumors with or without radiotherapy].

We analyzed 97 cases of various advanced or recurrent pelvic tumors which were cervix, rectal, ovarian and other tumors treated by intra-arterial infusion chemotherapy (IAIC) with or without radiotherapy. The IAIC regimen was separated into two groups: group I consisting of 5-FU + MMC +/- ADR (54 cases) and group II consisting of CDDP + MMC +/- 5-FU (43 cases) from 1985. The catheter was placed in the bifurcation of abdominal aorta, and from 1990, the catheters were placed in bilateral internal iliac arteries (8 cases). The overall response rate (CR + PR) was 65%, 74% in patients receiving radiotherapy, and 47% in those without radiotherapy. There were no significant differences between each primary site and presence of radiotherapy combination in survival rate. Two-year survival rate and 5-year survival rate was 32% and 15% for all cases, and 65% and 33% for CR cases, respectively. A significantly better survival rate was obtained in patients with CR. Five-year survival rate was 4% in group I, and 35% in group II (p = 0.00216) by chemotherapy regimen. Severe (more than grade III) hematological acute side effects were 45% for all cases. In 8 cases in which the catheters were placed in internal iliac arteries, there were severe skin ulcers in 2 cases, and severe pain of leg or gluteal region requiring narcotics in 3 cases. These data suggest that IAIC mainly with cisplatin with or without radiotherapy is one of the effective treatment for advanced or recurrent pelvic tumors. Also, we should check blood flow distribution periodically, and control the concentration of drugs.

Adolescent↗

[A case of myasthenia gravis associated with long-term phenytoin therapy].

A 22-year-old woman had been suffering from blepharoptosis and fatigabilities of both shoulders for a year. She had been administered phenytoin since age 4 to prevent febrile convulsion. On admission, she had bilateral blepharoptosis with left one being more severely affected. Her pupils and eye movement were normal. Other cranial nerve functions were normal. Her both deltoid muscles were mildly weak. A repetitive stimulation study revealed a 35% decline of the evoked responses recorded from either the orbicularis oculi or the abductor pollicis brevi muscle. Antibody activity for acetylcholine receptor was higher than normal range. Her blepharoptosis transiently disappeared after an intravenous administration of 5mg of edrophonium. She was diagnosed as having myasthenia gravis. Her myasthenic signs had continued one month after phenytoin withdrawal, then an extended thymectomy was done. The thymus was histologically hypertrophic. Although a direct blocking at a neuromuscular junction by phenytoin has been reported in animal experiments, our case is not likely to be affected by this effect. Since a large population of young epileptic patients needs a long-term phenytoin therapy, detailed investigation is necessary to elucidate how frequently they manifest myasthenia gravis.

Adult↗

Identification of a highly specific surface marker of T-cell acute lymphoblastic leukemia and neuroblastoma as a new member of the transmembrane 4 superfamily.

Five monoclonal antibodies detected a surface antigen expressed exclusively on T-cell acute lymphoblastic leukemia (T-ALL) in a panel of 45 human hematopoietic cell lines, including T-cell lines derived from adult T-cell leukemia and those established by immortalization with human T-cell leukemia virus type 1 or Herpesvirus saimiri. Peripheral blood mononuclear cells, including fresh and activated T cells, were also completely devoid of this antigen. We designated this antigen as TALLA-1 (from T-ALL-associated antigen 1). By expression cloning, a cDNA clone encoding TALLA-1 was isolated from T-ALL cell line Molt-4. TALLA-1 was found to be a member of the transmembrane 4 superfamily (TM4SF). The cDNA was also essentially identical to A15, which was isolated from another T-ALL cell line, HPB-ALL, by differential hybridization with normal peripheral blood lymphocytes, and to CCG-B7, which was isolated from a brain cDNA library using CCG repeat as a probe. The gene product was now characterized in detail at the protein level. Northern blot analysis showed that the gene was expressed most strongly in brain, skeletal muscle and spleen. In a panel of 52 non-hematopoietic human cell lines, the majority of neuroblastoma cell lines were found to be positive for TALLA-1. Like ME491, CO-029 and L6, TALLA-1 may be another TM4SF member behaving as a potential tumor-associated antigen.

Amino Acid Sequence↗

Clinicopathological features of MERRF.

Clinical features of MERRF are varied in terms of patterns and severity of symptoms at the early stage. The age of onset differs even in the same family. Occasionally, ragged-red fibers are not found upon the muscle biopsy. Pathological features in some patients are very mild in comparison with their clinical symptoms; genetic analysis is needed for diagnosis. Unique clinical features in members of three families with MERRF are reported.

Adolescent↗

Hereditary motor and sensory neuropathy associated with cerebellar atrophy (HMSNCA): a new disease.

Seven patients with hereditary motor and sensory neuropathy associated with cerebellar atrophy (HMSNCA) are presented. This is the first comprehensive evaluation of what is a unique disorder, half way between the cerebellar atrophies and the hereditary motor and sensory neuropathies. In addition to cerebellar ataxia and peripheral neuropathy, the most frequent features in HMSNCA were nystagmus, dysarthria, mental impairment and tremor. Pyramidal signs or autonomic nerve dysfunction was never revealed. Scoliosis or kyphoscoliosis was not noted. Progression of the disorder was very slow, most of the patients being ambulatory more than 10 years after the onset. Most of the patients had hypoalbuminemia. Half-life periods of serum albumin were normal and decreased synthesis of albumin in the liver was suspected. An autosomal recessive inheritance was strongly suggested, because of healthy consanguineous parents and affected siblings in these families. The segregation ratio was 0.32 +/- 0.10 and was close to the expected ratio of 0.25 in an autosomal recessive inheritance.

Adult↗

A family with adult type ceroid lipofuscinosis (Kufs' disease) and heart muscle disease: report of two autopsy cases.

Two cases in a family with Kufs' disease had lethal arrhythmias and heart muscle disease. Autopsy findings showed an abundant accumulation of lipofuscin-like lipopigments in most neurons in the central nervous system (CNS). The heart showed a slight increase in the accumulation of the lipofuscin-like lipopigments in the myocardial fibers, slight to severe fibrosis and infiltration of fat cells in the myocardium. The lipopigments both in the heart and in neurons of the CNS had curvilinear profiles on electron microscope and reacted immunohistochemically to polyclonal antibodies against subunit c of mitochondrial adenosine triphosphate (ATP) synthase. The degenerative process in this heart muscle disease might be attributable to the same metabolic abnormality as seen in the neuronal degeneration associated with Kufs' disease.

Arrhythmias, Cardiac↗

Involvement of dopamine, N-methyl-D-aspartate and sigma receptor mechanisms in methamphetamine-induced anticipatory activity rhythm in rats.

Daily injection of methamphetamine (MAP) increased the locomotor activity and produced the development of MAP-induced anticipatory activity on the next withdrawal day. Daily restricted feeding also causes a feeding-associated anticipatory activity rhythm. The importance of catecholaminergic neurons has been suggested in the manifestation of a feeding-associated corticosterone rhythm. In our study, we examined the role of dopaminergic neurons in the development of MAP-induced anticipatory activity. The development of MAP-induced anticipatory activity was blocked by coadministration of dopamine D2 receptor antagonists such as YM-09151-2 and sulpiride, the D1 receptor antagonist SCH23390 and haloperidol weak D1/D2 receptor antagonist, but not by clozapine. The anticipatory activity increase was reproduced by daily injection of the D2 receptor agonist quinpirole as well as moderately by the D1 receptor agonist SKF38393. Moreover, MAP-induced anticipation was blocked by coadministration of the N-methyl-D-aspartate receptor antagonist MK-801 or sigma ligands rimcazol and NE-100. Our results suggest that activation of the dopaminergic system, especially via D2 receptors may be required for the development of MAP-associated anticipatory activity increases and that N-methyl-D-aspartate receptors and sigma receptor mechanisms are also involved in the development of this behavior.

Animals↗

[A case of "apraxia of eyelid opening" secondary to right hemisphere infarction--assessment of various symptoms of the eye and eyelid].

A 68-year-old right-handed woman showed "apraxia of eyelid opening" during an acute phase of hemorrhagic infarction in the right middle cerebral artery distribution. She showed paradoxical contraction of the bilateral orbicularis oculi muscles both against our order to open her eyes and even against her hand-movement to help her eyes open, although she could voluntarily open her eyes. She was diagnosed as "apraxia of eyelid opening". Her eyes kept closed in most of time. Spontaneous blepharospasm and a right conjugate gaze preference were also seen. These symptoms disappeared 2 weeks after the hemorrhagic infarction. Because most of cases in previous reports as well as this patient showed "apraxia of eyelid opening" after a right cerebral involvement, we propose that this symptom may attribute to right cerebral dysfunction.

Acute Disease↗

[A case report of psittacosis and chlamydial isolation from a patient].

A 48-year-old female was seen at our hospital after having a severe fever of nearly 40 degrees C, for a period of 9 days. She complained of pain in the left side of her chest. An X-ray examination revealed a slight infiltration of the upper and middle lung fields. At this time, it was learned that the women's pet bird had recently died. This case was diagnosed as acute pneumonia due to psittacosis. Therefore the administration of Roxithromycin was started. After a few day her condition improved. During the course of treatment, serum was taken and a throat swab was done. A micro-immunofluorescence (MIF) test was performed to check the serum antibody levels against Chlamydia psittaci. The serum titer rose from 1:8 to 1:256 in 15 days after admission. The final diagnosis was made after positive isolation of C. psittaci by means of the cell culture method.

Adult↗

[Atypical Guillain-Barré syndrome associated with ophthalmoplegia and visual impairment following herpes simplex virus type 1 infection].

Two weeks after a flu-like illness, a 59-year-old woman developed double vision, muscle weakness and sensory discomfort in the proximal portions of her limbs. On admission, there was complete external ophthalmoplegia with bilateral ptosis. The pupils were dilated and did not react to light. Swallowing and elevation of the soft palate were also limited. There was severe muscle weakness in all limbs. Deep tendon reflexes were absent. Superficial and deep sensations were impaired in the proximal portions of the extremities. Neuro-ophthalmological examinations revealed an acquired color disorder with no scotoma and normal discs. P100 latencies of flashed visual evoked potentials were prolonged on day 41, and returned to normal on day 87. Herpes simplex virus type 1 (HSV-1) infection was confirmed by isolation of the virus from her sputum and the detection of anti-HSV-1 antibody in the acute phase serum.

Female↗

[A case of subacute sclerosing panencephalitis treated with intraventricular interferon--the side effects of interferon-alpha to the central nervous system].

A patient with subacute sclerosing panencephalitis (SSPE) was treated with an intraventricular alpha interferon (IFN-alpha) through an Ommaya reservoir. A 17-year-old boy, who had a history of measles exposure at age 1, showed forgetfulness, difficulties in calculation, reading and writing. Two months later he developed generalized convulsions and myoclonic spasms. He was admitted to the National Saigata Hospital in May 20, 1992. On admission, anti-measles antibody titer in the CSF was 1:16 by complement-fixation method. His EEG revealed a periodic synchronous discharge. Therefore, the diagnosis of SSPE was confirmed. An Ommaya reservoir was implanted on July 7, 1992, and an intraventricular administration of INF-alpha was begun after two weeks. The dose of INF-alpha was gradually increased from 1.0 x 10(6) IU/m2 to 2.0 x 10(6) IU/m2 twice a week. Fever, vomiting and anorexia were developed when the INF-alpha injection was first started. When he received a total dose of 8.0 x 10(6) IU, he became bed ridden for remarkable lethargy. The lethargy was continued for about 10 days despite the therapy was interrupted, and then he gradually became alert. The frequency of myoclonus became more frequent and mentality got worse, so the treatment with INF-alpha was tried again in decreasing the dose to 1.0 x 10(6) IU/m2 twice a week. However, be became drowsy again after he received a total of 7.5 x 10(6) IU. With intramuscular or intravenous administrations of the high doses of INF-alpha (> or = 1.0 x 10(7) IU), significant neurological abnormalities were reported to occur.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Proteolytic enhancement of human rotavirus infectivity.

Rotaviruses are the most important etiologic agents of severe diarrhea worldwide. Despite great advances in vaccine development, little is known about host protection mechanisms other than immunity. This presentation focuses on the proteolytic enhancement of rotavirus infection, with emphasis on the functions of VP4, an outer capsid protein. The in vitro growth of human rotavirus is enhanced by trypsin, which selectively cleaves VP4. Treatment with trypsin increases the infectivity of human rotavirus while decreasing its hemagglutination activity. There are two modes of rotavirus internalization: direct penetration with the aid of trypsin and endocytosis without trypsin. Direct penetration via VP4 cleaved by trypsin is essential for the replication of the virus, whereas endocytotic internalization does not give rise to viral replication.

Animals↗