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Biomedical subjects

T Akashi

Publications and source records attributed to T Akashi.

At least 19 recordsLinked to original sources
PubMed1992

Presenile dementia with progressive supranuclear palsy tangles and Pick bodies: an unusual degenerative disorder involving the cerebral cortex, cerebral nuclei, and brain stem nuclei.

Degeneration of heterogeneous systems in the central nervous system, with widespread distribution of argyrophilic neuronal fibrillary inclusions, was found in a patient with presenile dementia. Atrophy was circumscribed in the frontal and temporal lobes. Neuronal loss was severe in the basal ganglia, subthalamic nucleus, and substantia nigra. Immunocytochemical study using anti-phosphorylated tau and anti-ubiquitin antibodies in conjunction with ultrastructural observations revealed two types of inclusions: neurofibrillary tangles (NFTs) of progressive supranuclear palsy (PSP) in the Edinger-Westphal nucleus, locus coeruleus, cerebellar dentate nucleus, inferior olivary nucleus, and posterior horn of the spinal cord; and Pick bodies (PBs) in the atrophied cerebral cortex and red nucleus. PSP-type NFTs and PBs have been demonstrated in a single case for the first time. Despite their pathognomonic significance in certain disorders, we suggest that these inclusions may reflect a form of cytoskeletal disorganization, which is not entirely restricted to a single disease entity.

Adult↗
PubMed1992

[A study to clarify the mechanism of the usefulness of the macrolides--the influence of clarithromycin to biofilm with P. aeruginosa].

Clarithromycin (CAM) was administered long-term to patients with diffuse panbronchiolitis (DPB) to clarify the mechanism of the usefulness of the macrolides (MLs). 1. A tendency for clinical improvement was observed in 17 patients with DPB. Bacteria were eradicated in 7 of 9 patients with P. aeruginosa found in sputum. 2. A biofilm experimental model with P. aeruginosa was found to be destructed through constant contact with CAM and formed into a single cell with a smooth surface. 3. It was believed that the new lesion forming capability of P. aeruginosa that had been in contact with CAM was reduced due to a significant decrease in adherence to tissue. P. aeruginosa was principally eradicated by the host factors. These results suggested that the improvement in the prognosis of DPB with P. aeruginosa in the sputum after adding MLs was closely related to the destructive effect of the MLs on the biofilm.

Animals↗
PubMed1992

[The usefulness of the emergency hepatobiliary scintigraphy to rule out acute cholecystitis--43 patients report].

We studied emergency hepatobiliary scintigraphy in the 43 patients to rule out acute cholecystitis. After injection of 185-222 MBq (5-6 mCi) of 99mTc-EHIDA or 99mTc-HIDA, serial static scintigraphic images were obtained up to 7 hours in maximum. Of 43 patients in this study, 20 had a normal scan and finally in all of them cholecystitis was ruled out. Of the 43 patients, 14 had an abnormal scan (nonvisualized gall bladder). In 10 of them the diagnosis of acute cholecystitis was confirmed after emergency cholecystectomy. The other 9 patients of 43 had an incomplete scan mainly due to liver dysfunction. Four of them had acute cholecystitis in the cholecystectomy. These results indicate that acute cholecystitis can be excluded by the findings of gall bladder visualization in hepatobiliary scintigram. We concluded that emergency hepatobiliary scintigraphy is very useful to rule out acute cholecystitis.

Acute Disease↗
PubMed1992

[An autopsy case of untreated systemic lupus erythematosus with death from acute pulmonary hemorrhage].

An autopsy case of SLE died from acute and diffuse pulmonary hemorrhage is presented. A 50 year-old woman with SLE was admitted to our hospital because of high fever, butterfly rash, discoid skin lesions and renal dysfunction. She died from acute respiratory failure before initiation of the therapy with corticosteroid. Autopsy findings revealed a massive acute intrapulmonary hemorrhage. Histological study demonstrated a pulmonary arterial vasculitis with prominent fibrinoid necrosis at muscular pulmonary artery. No remarkable deposit of immunoglobulins and complements was found within the alveolar walls and pulmonary vessels by immunofluorescence and electron microscopy. Renal histology revealed diffuse proliferative glomerulonephritis with fibrinoid necrosis, crescent formation and wireloop lesions compatible with type IVb according to the WHO classification. The granular deposit of IgM, C3 and Clq, and electron dense deposit was found by immunofluorescence and by electron microscopy, respectively, in the kidney. The small arteries and veins in other organs, such as liver, spleen, bladder, ovary and rectum also revealed fibrinoid vasculitis. Acute infectious lesion was not observed in any tissue examined. The diffuse pulmonary hemorrhage in SLE could be one of the manifestations of active and severe systemic vasculitis.

Acute Disease↗
PubMed1991

[An autopsy case of idiopathic parkinsonism with numerous Lewy bodies in the cerebral cortex--diffuse Lewy body disease].

We report an autopsy case of a 73 year-old female with idiopathic parkinsonism, characterized pathologically by the wide spread appearance of Lewy bodies (LBs) not only in the pigmented neurons in the midbrain and brainstem but also in the cerebral cortex. Initial symptoms at the age of 62 were finger tremor and gait disturbance, which were followed mainly by mental deterioration, such as regression, dependency, auditory hallucination, depression, emotional incontinence, and a personality change. In the terminal stage, nuchal stiffness in extension, one of the hallmarks of progressive supranuclear palsy, and slow and generalized tremor in all 4 extremities were noted. She died of aspiration pneumonia. The brain was somewhat small and weighed 1100 g after the fixation by formalin. Macroscopical findings included mild cerebral atrophy with mild pial thickening both in the frontal and temporal lobes and slight expansion of the ventricular system. Histopathologically, severe loss of neuronal cells in both the pallidum and Luy's body and moderate loss of large cells in the putamen were noted in addition to the typical findings of Parkinson's disease in the substantia nigra and locus caeruleus including neuronal cell loss, depigmentation, and gliosis. These findings in the basal ganglia were more conspicuous than the two controls of classical Parkinson's disease. The distribution, stainability in the routine methods of staining, and shape of Lewy bodies in the cerebral cortex conformed to those of previous reports. The similar case reports in the literatures do not seem to have paid much attention to the findings of the basal ganglia observed in our case.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

HIV-1 env sequence variation in brain tissue of patients with AIDS-related neurologic disease.

We investigated sequence variation in the human immunodeficiency virus type 1 (HIV-1) env gene region that encodes the fourth disulfide-bonded domain of the external membrane glycoprotein, gp120, among three HIV-1 isolates from patients with AIDS-related neurologic disease. The sequences of HIV-1 isolated directly from brain tissue, blood cells, and in vitro cell cultures were compared. The results suggest that there may be many closely related HIV-1 genomes of several distinct subtypes in an HIV-1-infected individual. Differences were observed in the frequency distribution of sequence variants obtained from brain versus blood of the same individuals. Overall, the proportion of silent mutations is much lower than expected by random occurrence. Taken together, these results favor the possibility that selective forces may play a role in the tissue distribution of certain HIV-1 strains.

AIDS Dementia Complex↗
PubMed1991

Developmental expression of autoimmune target antigens during organogenesis.

A common factor existing among autoimmune target antigens was sought in association with their developmental expression during organogenesis. Autoimmunity against a certain organ was experimentally induced in rats by deliberate immunization with whole tissue extract of the respective organ. Histopathological changes in a target organ of the immunized rats were recorded, and tissue specificity of the raised autoantibodies was immunohistologically examined with tissue sections of normal adult rats. These immune sera were also reacted with tissue sections of a target organ in each stage of organogenesis, and the time of first expression of the target antigen was determined for each immune serum. As a result, induced autoantibodies were directed only to a limited number of tissue antigens, such as thyroid follicular antigens [gestation day 17 (17 GD)], salivary ductal antigens (18 GD), anterior pituitary antigens (21 GD), gastric parietal cell antigens (22 GD), neural myelin antigens (2 days after birth), retinal photo-receptor cell antigens (3 days after birth) and testicular germ cell antigens (4 weeks after birth). They were first expressed on the day indicated in parentheses. Comparing with the development of the immune system, which was monitored by demonstrating CD4- and/or CD8-positive cells in the developing thymus and spleen, a common feature of these potential autoimmune target antigens was found to be that they were expressed either in parallel with, or after, but never before, the development of the immune system. This observation might suggest why only a limited number of self antigens can be autoimmune target antigens among the enormously large number of antigen determinants existing in the whole extract of each organ.

Animals↗
PubMed1990

Involvement of the locus coeruleus in Pick's disease with or without Pick body formation.

Brains affected by the fronto-temporal type of Pick's disease were classified into two subgroups according to whether Pick bodies (PBs) were detectable in cerebral cortex (PB-positive group, six cases) or not (PB-negative group, eight cases), and examined neuropathologically. Controls included seven patients with non-degenerative diseases. The neuronal population in the locus coeruleus (LC) was estimated quantitatively in preparations from the middle part of the LC. The data were analyzed statistically by the Mann-Whitney U-test. Histological and ultrastructural studies were also carried out. The following results were obtained: (1) there were no appreciable differences between the PB-positive and PB-negative groups with regard to age at onset, age at death, duration of illness, clinical stage at death, and brain weight; (2) the mean nerve cell counts in the LC were 43.7 +/- 5.2 in the controls, 28.8 +/- 11.7 in the PB-positive group, and 42.9 +/- 7.6 in the PB-negative group. The nerve cell count in the PB-positive group was significantly lower (P less than 0.05) than those in the controls and the PB-negative group; and (3) in each of the PB-positive cases, PBs were disclosed in the LC, in medium-sized melanin-laden neurons and small neurons. PBs were globular or lobulated, and their fine structure was identical to that of typical PBs in the cerebral cortex. In conclusion, PB formation may play an important role in neuronal decrease in the LC of PB-positive cases, whereas the LC may not be affected in PB-negative cases. In this respect, Pick's disease with PB formation appears distinct from that without PB formation.

Aged↗
PubMed1990

Immunopathological analysis of interstitial renal lesions in elderly people.

The incidence of focal lymphoid infiltrates in the renal interstitium was examined in autopsy cases of young and old subjects, and the infiltrating lymphocytes were immunohistologically characterized by a panel of monoclonal antibodies. Histologically, 198 and 227 autopsy cases over 60 years of age (87.2%) were shown to have mononuclear cell infiltrates of varying degree in the renal interstitium, whether or not these were accompanied by progressive arteriosclerotic changes. Above all, severely infiltrating foci in the renal interstitium were frequently found in the elderly over 70 years of age overlapping arterio-artherolosclerotic changes. In contrast, in the 54 younger control subjects under 49 years of age, the incidence of such a lesion was less (5.6%). An immunohistologic study revealed that the infiltrating mononuclear cells were predominantly composed of CD4+ cells, whereas CD22+ B cells were apparently lesser in number. Moreover, a considerable proportion of T cells was activated as judged by IL-2 receptor expression. From these findings, we now propose that susceptibility to the development of interstitial renal lesions in the elderly involves the cellular immune response, and may be related to an age-associated disturbance in regulatory T-cell function.

Aged↗
PubMed1990

[Clinical usefulness of scintigraphy with 99m technetium phosphates in rhabdomyolysis].

We performed bone scans with 99mTechnetium phosphates in 15 cases of clinically suspected rhabdomyolysis admitted to Chigasaki Tokushukai Hospital. Whole body scans were performed within 5 days from the onset of illness or admission. Accumulation of the radioactivity in the skeletal muscle was revealed in 13 of the 15 cases and the involved muscle groups were visualized vividly. Etiologies of rhabdomyolysis were diverse, ranging from malignant syndrome to sepsis. Myocardial concentration was absent in all of the cases. Renal concentration of the isotope was seen in cases where the degree of rhabdomyolysis was higher and renal impairment was present. We conclude that 99mTechnetium phosphate bone scan is useful in clinically suspected rhabdomyolysis as a diagnostic test and as a test to localize and quantitate the muscular involvement.

Adult↗
PubMed1989

A large degenerated subserous leiomyoma of the uterus: uncommon scintigraphic and ultrasonographic findings.

Bone imaging is commonly used as a sensitive indicator of metastatic bone diseases or other bone pathology. Furthermore, it is now generally known that technetium-99m (99mTc) phosphonates tend to concentrate in various tissues other than bones. Ultrasonography is also widely used for the evaluation of pelvic masses. Ultrasonography is especially useful for detecting a cystic mass. We present a case where the uptake of 99mTc phosphonate compounds occurred in the entire abdomen, and ultrasonography suggested a diagnosis of pseudomyxoma peritonei, but the condition was later proven to be degeneration of giant subserous leiomyoma of the uterus. We have found two interesting features in this case. One is the 99mTc phosphonate concentration in the large cystic and hyaline degeneration of subserous leiomyoma of the uterus without calcification, and the other is the sonographic finding of a large echogenic mass with innumerable small anechoic areas. To our knowledge, no cases of 99mTc phosphonate concentration in non-calcified leiomyoma of the uterus have been demonstrated.

Adult↗