Biomedical subjects
Publications and source records attributed to N Maki.
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BACKGROUND AND PURPOSE: The Short-Memory Questionnaire (SMQ) developed by Koss et al. is a standardized, validated reliable informant-based scale to assess everyday memory problems. In the previous study, we prepared its Japanese version and validated the reliability in assessing patients with Alzheimer Disease. In the present study, we examined the relations between the performance evaluated by the Japanese version of the SMQ combined with the Mini-Mental State Examination (MMSE) and demographic variables (age, sex, and education). SUBJECTS AND METHODS: Subjects were a total of 613 elderly healthy individuals living in the rural residency of Nakayama, Japan. They consisted of 287 males and 326 females and ranged from 65 to 94 years in age and from 0 to 16 years in education. The MMSE was conducted by neuropsychiatrists to assess the severity of cognitive impairment, and the SMQ was conducted by public health nurses, who asked a family member of each subject. The effects of age, sex and education on the MMSE and SMQ scores were analyzed by analysis of variance (ANOVA) using post-hoc Scheffé test. RESULTS: The mean MMSE and SMQ scores (+/- SD) were 27.6 (+/- 2.5) and 44.5 (+/- 2.1), respectively. The post-hoc Scheffé test revealed significantly higher MMSE scores for individuals with 8 years or more in education than for those with less than 8 education years. Between males, no significant differences were observed in MMSE score; however, among females, significantly higher scores were noted in those aged 69 or younger than in those aged 70-74 or those aged 80 or older. Of individuals aged 80 or older, males showed significantly higher scores than females, whereas no significant differences were observed between sex in other age groups. As to the SMQ, higher scores were shown by persons with longer education years and by females than males. CONCLUSION: Low MMSE scores were related to low education level and older females. Low SMQ scores were not related to aging, but linked to low education level and males. Both the MMSE and SMQ, which can be easily administered, are affected by education years and sex. In addition, MMSE score depends on age. Therefore, careful consideration should be paid to age, education level and sex for future execution of the MMSE and SMQ.
Front-temporal dementia (FTD), advocated by Lund and Manchester groups, includes Pick type corresponding to the conventional frontal Pick's disease, motor-neuron type associated with neural symptoms, and frontal lobe degeneration type. In Japan, however, there have been few case reports of the frontal lobe degeneration type. Here we examined clinical characteristics and imaging findings of 2 cases of FTD frontal lobe degeneration type. Neurological examinations were normal. CT and MRI scans revealed no obvious frontal lobar atrophy, while HMPAO-SPECT scans demonstrated remarkable hypoperfusion in anterior hemisphere. Neuropsychological examination revealed frontal symptoms, including personality change, stereotypes, and disinhibition. These symptoms can not be distinguished from the cases of FTD Pick type, because those cases of FTD Pick type have obvious lobar atrophy.
A 64-year-old Japanese male was admitted to Kotoh General Hospital because of fever and cough on July, 14, 1997. Laboratory data showed hypereosinophilia (11,500/microliter) and high titer of anti-myeloperoxidase antineutrophil cytoplasmic antibody (319 EU). A physical examination revealed progressive peripheral neuropathy. He had been diagnosed as having bronchial asthma since November, 1996. Therefore, he was diagnosed as having Churg-Strauss syndrome (CSS). He was treated with methylprednisolone pulse therapy (500 mg/day for 3 days) and oral prednisolone (PSL, 60 mg/day). However, peripheral neuropathy was rapidly progressive, and echocardiogram revealed cardiac hypofunction (ejection fraction (EF); 39%). He was refereed to Akita University Hospital for further examination. On admission, laboratory data showed hyponatremia (125 mEq/l) with inappropriate secretion of antidiuretic hormone (ADH, 13.0 pg/ml). Atrial natriuretic peptide was normal (26 pg/ml). Urinary osmorality was 488 mOsm/l, and urinary sodium excretion was 86 mEq/l. Renal, adrenal, and thyroid functions were normal. From these data, his hyponatremia was caused by syndrome of inappropriate secretion of ADH (SIADH). After cyclophosphamide-pulse therapy (500 mg) and oral administration of cyclophosphamide (50 mg/day) and PSL (50 mg/day), peripheral neuropathy improved gradually, and his serum sodium returned to normal, but cardiac hypofunction continued. A possible relationship between SIADH and CSS is discussed.
BACKGROUND: Except for Reye's syndrome, influenza-associated acute encephalopathy or encephalitis is not universally recognised. We did a multicentre study of laboratory and clinical data for patients with influenza-associated acute encephalopathy or encephalitis. METHODS: In Nagoya, Japan, ten patients with acute encephalopathy or encephalitis associated with influenza-like illness were admitted to our hospitals between April, 1996, and March, 1997. We collected clinical, laboratory and serological data and assessed cerebrospinal fluid samples by PCR for influenza A and B. FINDINGS: Seven patients, aged 22 months to 4 years, had evidence of recent influenza infection, six with type-A/Hong Kong (H3N2) and one with type B. The first sign in the central nervous system appeared within 2 days of fever in all but one patient. The first sign of involvement of the central nervous system was generalised convulsions in all patients. Two patients died, one had sequelae, and four survived without sequelae. PCR for influenza type A was positive for five patients. INTERPRETATION: The results of PCR suggest that at least part of the influenza type A genome existed in the central nervous system. Influenza-associated acute encephalopathy or encephalitis in young children deserves wider recognition.
PURPOSE: To evaluate the relationship of total-dose of daunorubicin (DNR) to the induction therapy and treatment outcome, we have administered individualized doses of DNR during induction treatment to patients with acute myelogenous leukemia (AML). PATIENTS AND METHODS: Ninety-two previously untreated adult patients with AML who entered our hospital were analyzed for the dose of DNR required to achieve complete remission (CR), the CR rate, disease-free survival (DFS), and overall survival (OS). Induction therapy consisted of DNR 40 mg/m2 daily intravenously from day 1 until the marrow was hypoplastic, cytarabine (Ara-C), prednisolone (PRD), and/or 6-thioguanine (6-TG). RESULTS: Eighty-three of 92 patients with adult AML were assessable for this study. Sixty-three (76%) patients achieved CR. Fifty-two of 63 CR patients achieved the CR in the first course of induction therapy, and 11 patients required the second course of induction therapy. The 5-year and 10-year DFS rates were 31.2% and 5-year and 10-year OS rates were 45.1% and 42.3%, respectively. The median total dose of DNR in the induction therapy was 280 mg/m2 (120 to 480 mg/m2). DNR dose did not influence the response to therapy and was not influenced by the initial WBC count or French-American-British (FAB) system classification. CONCLUSION: These results indicated that when the dose was linked to observed tumor response, the optimal dose of DNR in the induction therapy was approximately 280 mg/m2 (40 mg/m2 for 7 days), which is greater than the conventional dose of 40 to 60 mg/m2 for 3 days.
BACKGROUND AND PURPOSE: Memory deficit is a common sign of Alzheimer's disease (AD), which appeared generally in the early stage of the disease. Therefore, evaluation of memory is important for management of patients and for clinical research of AD. The Short-Memory Questionnaire (SMQ), an easily administered, informant-based scale, which was developed by Koss et al. (1993), is a standardized, validated, and reliable tool to assess everyday memory problems. In the present study, we prepared a Japanese version of the SMQ and examined its reliability and validity in assessing AD patients. SUBJECTS AND METHODS: The subjects consisted of 42 patients with NINCDS-ADRDA probable AD whose diagnosis was made on the basis of the results of comprehensive examinations including cranial CT/MRI and SPECT and age- and education-matched 53 healthy controls. Patients had no history of stroke, head injury, or any other prior neurological events. Patients and controls were between the ages of 51 and 90 years, and they had from 6 to 16 years education. The Japanese version of the SMQ was given to a family member by either neuropsychiatrist, public nurse or case worker. To evaluate test-retest reliability of the test, interview was repeated in 16 randomly selected patients by two different examiners (neuropsychiatrist and another) in two weeks interval. The Mini-Mental State Examination (MMSE) was used to assess the severity of cognitive impairment. RESULT: The test-retest reliability was acceptably high with intraclass correlation coefficients. There was a high correlation between scores of SMQ and MMSE. The SMQ had excellent specificity and sensitivity in discriminating patients from controls. Caregiver appraisals of memory deficits significantly correlated with generalized cognitive dysfunction. CONCLUSIONS: Similarly to the original version, the present Japanese version of the SMQ is a reliable and valid tool in assessing memory function in AD, which can be effectively used in clinical settings and epidemiologic studies to screen out persons with memory problems.
To evaluate the prognostic significance of CD7 expression in de novo acute myeloid leukemia (AML), we studied 63 patients with AML who had been admitted to our hospital between September 1989 and January 1996. Even of the patients were later eliminated from the study (9 due to insufficient surface marker analyses, and 2 due to early death). The remaining 52 patients (median age: 42.5 years) were evaluated for morphologic subtype, immunophenotypic classification, complete remission (CR), disease-free survival (DFS) and overall survival (OS). All 52 patients were grouped by the French-American-British classification system: 10 as M1, 16 as M2, 11 as M3, 8 as M4, 5 as M5, and 2 as M6. Ten of the patients expressed CD7 on their leukemia cells (positive rate > or = 25) and were classified as CD7(+)AML, with morphological subtypes as follows: 3 as M1, 6 as M2, and 1 as M3. Thirty-three of the 42 patients with CD7 + AML (78.6%) and 6 of the 10 patients with CD7 + AML (40%) achieved CR. DFS and OS rates for the patients with CD7(+)AML were 22.1% and 35.4%, respectively; those for the CD7(+)AML patients were 53.3% and 44.4%, respectively. No significant differences in gender hematological findings, clinical manifestations such as hepatosplenomegaly, lymphadenopathy, or incidence of central nervous system involvement, CR rate, and DFS distinguished patients with CD7(+)AML from those with CD7(+)AML. These suggest that CD7 expression is unlikely to be a prognostic factor in AML.
Our previous study demonstrated that pro-gastrin-releasing peptide(31-98), or ProGRP, is a specific tumor marker in patients with small cell lung carcinoma (SCLC). Using a newly developed, highly sensitive enzyme-linked immunosorbent assay (ELISA) for ProGRP, we analyzed 1,446 samples including those obtained from 478 lung cancer patients to evaluate the clinical usefulness of this ELISA. Several properties indicated that ProGRP is a useful tumor marker for SCLC. First, ProGRP was specifically elevated in SCLC patients. In non-SCLC patients and patients with non-tumorous lung diseases, its serum level was very rarely elevated. Secondly, ProGRP was a reliable marker, in terms of the marked elevation of serum ProGRP levels in SCLC patients. Thirdly, serum ProGRP levels were elevated in SCLC patients even at a relatively early stage of this disease. Fourthly, changes in the serum ProGRP level showed an excellent correlation with the therapeutic responses in SCLC patients. Neuron-specific enolase (NSE) is accepted as a tumor marker of SCLC patients. With the aim of comparing ProGRP and NSE as tumor markers for SCLC patients, we measured serum NSE levels in all samples collected in the present study. We found that ProGRP was superior to NSE in terms of sensitivity, specificity and reliability. Therefore, we consider that ProGRP can play a major role as a clinical tumor marker for SCLC patients.
Comparative nucleotide sequence studies on the putative NS3 and NS4 regions of the genomes of hepatitis C viruses (HCV) have revealed that there are at least two groups of HCV, group I and group II. The cDNA clone E, corresponding to a boundary between the NS3 and NS4 (NS3-4) region of the group II HCV genome, encodes antigens that react to antibodies specific to group II HCV (Tsukiyama-Kohara et al. (1991) Virus Genes 5, 243-254). To understand the molecular basis of the group-specific antigenicity of HCV peptides, the predicted amino acid sequences around the NS3-4 region of our group II HCV cDNAs were compared with those of other HCV isolates. The analysis revealed the presence of group-specific amino acids in this peptide region. Evolutionary analysis of nucleotide sequences within this region of these HCV isolates also led to the same classification. A similar result was obtained by sequence analysis of cloned cDNAs corresponding to the core region. A cDNA of the group II HCV core region was prepared by polymerase chain reaction from the cDNA synthesized with group II-specific primer complementary to the NS3-4 region. The products directed by the cDNA of the core region did not have group-specific antigenicity. The NS3 peptide region also appeared not to carry group-specific antigens. Our results indicate that most HCV isolates can be classified into either group I or II, and that the existence of two groups of HCV does not disturb HCV diagnosis as long as core and/or NS3 peptides are used to detect HCV antibodies.
OBJECTIVE: The purpose of our study was to evaluate the hypothesis that pregnancy is associated with decreased platelet-activating factor-acetylhydrolase activity in women with normotension, but not in women with hypertension. STUDY DESIGN: We evaluated plasma platelet-activating factor-acetylhydrolase activity in normal nonpregnant women (n = 10), normal pregnant women (n = 24), pregnant women with pregnancy-induced hypertension-preeclampsia (n = 7), and a group of men with normotension (n = 10). RESULTS: Platelet-activating factor-acetylhydrolase activity was lower at 32 weeks of gestation during normal pregnancies compared with nonpregnant controls (p < 0.001); however, in women with pregnancy-induced hypertension-preeclampsia, platelet-activating factor-acetylhydrolase activity was not decreased. Platelet-activating factor-acetylhydrolase activity in men was higher than in all women (p < 0.01). CONCLUSION: Pregnant women with normotension may be refractory to pressor agents such as angiotensin II in part because of the decrease in plasma platelet-activating factor-acetylhydrolase activity, which results in an increase in platelet-activating factor. In contrast, enzyme activity is not decreased in pregnant women with hypertension, who have increased sensitivity to various pressor agents.
One of the lipid mediators, platelet-activating factor (PAF), is reported to be involved in a variety of biological phenomena including not only harmful reactions such as allergy or inflammation, but also physiological phenomena like nerve cell differentiation, sperm mobilization, ovulation, implantation, parturition etc. We reviewed the methods of detecting PAF in biological fluids and the effects of PAF on fetal lung maturation and pulmonary diseases. Fetal lung has a capacity to produce PAF and this autacoid is involved in glycogen breakdown to furnish both glycerol backbone, such as dihydroxyacetone phosphate and glycerol-3-phosphate, and the fatty acids utilized to synthesize pulmonary surfactant. PAF also enhances secretion of pulmonary surfactant. However, PAF causes eosinophil recruitment to the lung, activation of eosinophil and neutrophil, bronchoconstriction, and lung edema, and increases bronchial hyperreactivity. All are characteristics of the pathophysiology of bronchial asthma. We examined PAF acetylhydrolase activity in plasma from patients with bronchial asthma, and found the activity was significantly lower in severe cases than that in mild or moderate cases. Ketotifen had no effect on this enzymatic activity. Evaluating PAF acetylhydrolase activity may help determine the severity of bronchial asthma. PAF is also involved in chronic lung disorders of newborns, such as bronchopulmonary dysplasia. We treated a 3-month-old child with frequent pulmonary problems who was made a diagnosis of bronchopulmonary dysplasia during neonatal period. After administration of Ketotifen for one and a half months, his clinical symptoms improved dramatically.
We have molecularly cloned the complete genomic DNA of TM2 strain of feline immunodeficiency virus (FIV) isolated in Japan and compared its nucleotide and the deduced amino acid sequence with those of previously described U.S. isolates, FIV Petaluma and FIV PPR. The infectious molecular clone of FIV TM2 is different from FIV Petaluma in host cell range; the clone can not infect Crandell feline kidney cells which were permissive for FIV Petaluma. The amino acid sequence homologies, in gag, pol, and env genes between FIV TM2 and Petaluma were 90%, 87%, and 81%, respectively. On the other hand, comparative analysis of each gene between FIV Petaluma and PPR showed 96,95, and 85%, respectively. These results suggested that the genomic diversity was present among FIV strains isolated from geographically distant areas. Interestingly, tat- and rev-like short open reading frames contained inframe stop codons in the FIV Petaluma but not in the FIV TM2.
Complementary DNA clones corresponding to one of the putative structural regions of the hepatitis C virus (HCV) genome were obtained from sera of non-A non-B hepatitis patients. The putative envelope gene was expressed by using a recombinant vaccinia virus carrying this region of the HCV genome. In cells infected with the recombinant vaccinia virus, a glycosylated protein with an M(r) of about 35K (gp35) was specifically detected by convalescent sera from hepatitis C patients. The sera from rabbits immunized with this recombinant vaccinia virus reacted to the gp35 produced in insect cells and also to gp35 which was translated in vitro in the glycosylated and processed form. The gp35 was used to detect antibodies in sera of only 7 to 23% of HCV patients at various stages of HCV disease. These results suggest that the gp35 of HCV may not have high antigenicity in humans.
Peptidylprolyl-cis-trans-isomerase (PPIase) is thought to be essential for protein folding in the cell. Two forms, a and b, of PPIase and their corresponding genes were isolated from Escherichia coli cells. Despite their insensitivity to cyclosporin A (CsA), both amino acid sequences were homologous and related to that of pig cyclophilin, a protein that has PPIase activity sensitive to CsA (Takahashi et al., 1989). PPIase a is found to be identical with the E. coli ORF 190 gene product that was sequenced by Kawamukai et al. (1989) and overexpressed by Liu and Walsh (1990). It is translocated into E. coli periplasmic space with the signal sequence. PPIase b lacks a hydrophobic amino acid stretch which could serve as a signal sequence or a transmembrane domain, and it is detected mainly in the bacterial cytoplasm. These findings indicate that proteins with the ability to assist folding of various polypeptides are located on both sides of the inner membrane. Thus, we propose that the folding of some exported proteins may be catalyzed by the periplasmic proline isomerase and, in turn, that some proteins which have isomerized may not be translocated efficiently.
cDNA clone 11-7 was isolated by immunoscreening a cDNA library that was prepared from a pooled plasma of non-A non-B hepatitis (NANBH) patients using expression vector lambda gt11. This cDNA corresponds to known nucleotide positions 3983-4745 of the genome of hepatitis C virus (HCV). This clone was used as a probe for screening the HCV-related cDNAs in a cDNA library similarly prepared by using lambda gt10. As a result, six more cDNA clones were isolated and analyzed for their nucleotide sequences. The results strongly suggested that there are at least two groups of HCV, group I and group II. According to our classification, the prototype HCV and clone 11-7 belong to group I HCV, and their nucleotide and deduced amino acid sequences were diverged from those of group II HCV. Genetic variation observed in the nucleotide and the amino acid sequences between the two groups resembles that in the NS3 region of the genome between Japanese encephalitis virus and West Nile fever virus. Polypeptides produced in Escherichia coli carrying a clone 11-7 or a group II cDNA clone E reacted with antibodies in the blood of 12 or 4 out of 14 individual chronic NANBH patients, respectively. Our data clearly indicate the existence of a second group of HCV.
We have previously reported that certain fetal tissues including the lung and kidney have an increased platelet-activating factor (PAF) content and enzymatic mechanism for its elevated biosynthesis during the latter stages of pregnancy. In contrast, in the maternal plasma compartment of both the rabbit and human, a decreased capacity to inactivate PAF has been demonstrated. The PAF acetylhydrolase in the fetal plasma is also suppressed. The present study was undertaken to determine the mechanism(s) involved in the regulation of PAF acetylhydrolase. The 17 alpha-ethynylestradiol was administered (intraperitoneal [i.p.] 2.5 mg/kg body wt 5 days) to female and male rats. The plasma PAF acetylhydrolase activity decreased 5-fold. A decrease was observed when a concentration of the estrogen as low as 50 micrograms/kg was employed. The injection of dexamethasone (i.p., 1.3 mg/kg body wt, 5 days) to male and female rats resulted in a 3-fold increase in the plasma PAF acetylhydrolase activity. The activity returned to the values prior to hormone treatment 4 days after cessation of treatment. Testosterone and progesterone were without effect on plasma acetylhydrolase activity. The change in PAF acetylhydrolase activity caused by estrogen and the glucocorticoid was reflected by a change in the activity in the HDL fraction and not due to the presence of an inhibitor or activator in the plasma of the hormone-treated animals. Human serum obtained from a group of women, in which the 17 beta-estradiol concentration was elevated in preparation for an in vitro fertilization procedure, showed an inverse relationship between the plasma estrogen concentration and the PAF acetylhydrolase activity.(ABSTRACT TRUNCATED AT 250 WORDS)