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Biomedical subjects

T Miike

Publications and source records attributed to T Miike.

At least 91 records · Page 5Linked to original sources

Atypical Prader-Willi syndrome with severe developmental delay and emaciation.

A young boy showed features of Prader-Willi syndrome including hypotonia, cryptorchidism, a mildly dysmorphic facial appearance, a high-arched palate and an open triangular-shaped mouth, but had additional symptoms such as simian creases and multiple joint ankylosis in early infancy. Deletion of the long arm of chromosome 15(q11.2 to q13) was recognized. A muscle biopsy specimen showed variation in fiber size with hypertrophic type 1 fibers, type 2 fiber smallness, type 2B fiber paucity and an increased number of type 2C fibers. At the age of 4 1/2 years, he still showed severe developmental delay with severe muscle hypotonia, weakness and emaciation.

Child, Preschool↗

Vascular endothelial cell injury and platelet embolism in Duchenne muscular dystrophy at the preclinical stage.

Blood vessels in muscle biopsy specimens from 4 Duchenne muscular dystrophy (DMD) patients (including 3 at the preclinical stage) were examined by electron microscopy and compared with those in non-diagnostic biopsy specimens from age-matched controls and cases of other childhood neuromuscular disorders. The most striking feature was the blister-like swelling of vascular endothelial cells in the biopsied muscle specimens from the 3 preclinical stage DMD patients, which was observed in 23-39% of the small blood vessels examined. Other noticeable features in the preclinical DMD patients were: (1) replication of the basement membrane, there being more than 3 layers in 30% of the capillaries; (2) many degenerating and regenerating capillaries; and (3) platelet adhesion and aggregation in small blood vessels including small arteries and veins. Morphometric analysis showed that the capillary and endothelial cell areas were much greater in the preclinical DMD patients than in the controls or the cases of the other neuromuscular disorders. These phenomena strongly suggest an as yet undetermined process in blood vessels in preclinical DMD.

Biopsy↗

Familial mitochondrial encephalomyopathy with stroke-like episodes and episodic disturbances of consciousness: a study of pedigree including three generations with multisystemic abnormalities.

We report here two cases in a family with pleomorphic clinical features which include mitochondrial myopathy, encephalopathy, stroke-like episodes, episodic disturbances of consciousness and other multisystemic abnormalities. The other signs observed in multisystemic abnormalities were ophthalmoplegia, short stature, diabetes mellitus, diabetes insipidus, renal dysfunction, optic atrophy, retinal degeneration, impairment of hearing and mental retardation or deterioration. A symptomatological variation was observed in cases in the same family. It is suggested that these widely varying symptoms may be expressions caused by a common biochemical defect which involves different tissues in different individuals in the family. The syndromes observed in the present cases were compared with other possibly-related mitochondrial encephalomyopathies.

Adult↗

Heterogeneous phenotypes of mitochondrial encephalomyopathy in a single kindred.

Five patients with mitochondrial disorders in a single family showed marked heterogeneity of clinical signs and symptoms. Two patients had the syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes; one had blepharoptosis, seizures, and diabetes insipidus; and two had a nonspecific encephalomyopathic disorder. This family supports the concept of a "mitochondrial cytopathy."

Acidosis, Lactic↗

Increase of T cells bearing Fc epsilon R-associated antigen in patients with atopic asthma.

Subpopulations of peripheral blood mononuclear cells (PBMC) in patients with atopic asthma and control donors were analyzed by means of flow cytometry. T cells were isolated from PBMC by rosetting with sheep erythrocytes. The proportions of PBMC and T cells bearing receptors for Fc fragment of IgE (Fc epsilon R) were elevated in patients when determined with monoclonal antibody to Fc epsilon R-associated antigen (H107). Significant correlations were observed between the serum-IgE levels and proportions of Fc epsilon R+ T cells (r = .71, P greater than .002). In contrast, no differences were observed between the groups in the proportions of PBMC and T cells bearing receptors for Fc fragment of IgG (Fc8R) when measured with model IgG-immunocomplexes. The proportions of cells reacting with monoclonal anti-IgE (9G2), T11 (E receptor), Leu-2a (suppressor), Leu-3a (helper), Leu-4 (pan-T), Leu-12 (pan-B), and anti-polyvalent immunoglobulin did not differ significantly between the groups. The results indicate that Fc epsilon R+ T cells are increased in patients with atopic asthma, suggesting that these cells may be involved in the regulation and/or synthesis of IgE antibody formation in man.

Adolescent↗

Pathology of skeletal muscle and intramuscular nerves in infantile neuroaxonal dystrophy.

Biopsies of the biceps muscle and sural nerve were taken from a girl aged 2 years with infantile neuroaxonal dystrophy (INAD). In addition to the typical axonal spheroid bodies in a number of the i.m. nerve fibers, the neuromuscular junctions (NMJs) and motor nerve endings also contained axonal swellings. The sural nerve, except for three dystrophic fibers, was almost completely normal. A teased nerve preparation showed four additional abnormal fibers with focal axonal enlargement similar to those in giant axonal neuropathy (GAN). These results suggest that a biceps muscle biopsy may be more useful than a sural nerve biopsy for the diagnosis of INAD, because the muscle contains abnormal peripheral nerves and NMJs in high frequency.

Axons↗

Mitochondrial cytopathy with lactic acidosis, carnitine deficiency and DeToni-Fanconi-Debré syndrome.

We reported a 6-year-old girl with mitochondrial cytopathy with lactic acidosis. The patient developed hypotonia, hearing loss, mental retardation, short stature, cataracta, hypoparathyroidism, DeToni-Fanconi-Debré syndrome and carnitine deficiency. Histological examination disclosed ragged red fibers and moderate lipid storage in skeletal muscle tissue and several structural abnormalities of mitochondria both in muscle tissue and proximal renal tubules. Biochemical examination of muscle tissue revealed a partial deficiency of pyruvate dehydrogenase complex and normal activities of cytochrome c oxidase, succinate cytochrome c reductase and NADH cytochrome c reductase. This is the first report of mitochondrial cytopathy representing DeToni-Fanconi-Debré syndrome associated with partial deficiency of pyruvate dehydrogenase complex and normal cytochrome c oxidase activity.

Acidosis, Lactic↗

Muscle fiber type transformation in nemaline myopathy and congenital fiber type disproportion.

In a morphometric study on biopsied muscles from 5 patients with nemaline myopathy (NM) and 5 with congenital fiber type disproportion (CFTD), the common findings were relative type 1 fiber smallness, type 1 fiber predominance and occasional hypertrophic type 2 fibers. In NM, the relatively larger type 1 fibers increased in number with age in parallel with a decrease in the number of normal to hypertrophic type 2 fibers, reflecting active fiber type transformation from type 2 to type 1, which resulted in striking type 1 fiber predominance. The presence of scattered non-atrophic type 2C fibers also reflected active fiber type transformation because the fibers during the maturational or degenerating process are known to show the type 2C reaction on ATPase staining. On the other hand, the type 1 fibers in CFTD were small in caliber and showed minimal variation in size, suggesting practically no fiber type transformation from hypertrophic type 2 to type 1.

Child↗

Unusual case of diffuse connective tissue disease with nodule formations in muscle, lung, kidney and brain.

A 9-year-old boy had nodular masses in the left gastrocnemius muscle and lung, right kidney and right frontal area of the brain. Laboratory examinations, including positive anti-nuclear antibody, anti-RNP antibody, RA and CRP, hyper-gamma-globulinemia and accelerated ESR, showed characteristic of diffuse connective tissue disease (DCTD). Biopsy specimens were obtained from the thymus and from masses in the left lung and gastrocnemius muscle. The thymus showed hyperplasia, and a mass in the lung showed nonspecific inflammatory reactions such as connective tissue proliferation and cellular infiltration. Biopsied muscle also showed severe connective tissue proliferation, cellular infiltration, variation in fiber size and thickened blood vessel walls. In addition, abnormalities, including thickening of the basement membrane and an almost occluded narrow lumen of capillaries, were found on electron microscopy examination. Steroid administration led to remarkable improvement of the symptoms. These results suggested that DCTD is responsible for these symptoms.

Biopsy↗

An electron microscopical study of the T-system in biopsied muscles from Fukuyama type congenital muscular dystrophy.

The behavior of the tubular system in muscles from six patients with Fukuyama type congenital muscular dystrophy (FCMD) was examined by electron microscopy using a lanthanum nitrate stain for a comparison with that in Duchenne muscular dystrophy (DMD). In FCMD, many fibers showed morphological changes of the T-system as follows: aggregated tubular components forming honeycomb-like structures, focal dilatation of T-tubules with tangle formation, and numerous longitudinally projecting tubules, which were quite similar to those found in cases with DMD. The fibers with abnormal T-systems occasionally showed ultrastructural characteristics of regenerating fibers, including excessive ribosome particles, immaturely organized myofibrils, and an increased number of internal nuclei and satellite cells. The present results suggested that there was no qualitative difference in the behavior of the T-system between FCMD and DMD, and the morphological changes of the T-system in dystrophic muscles were not primary lesions initiating myonecrosis but reflected the behavior of sarcotubular formation in the process of muscle regeneration.

Animals↗

Behavior of sarcotubular system formation in experimentally induced regeneration of muscle fibers.

To examine the behavior of transverse (T)-tubule formation in experimentally-induced regenerating fibers, a local anesthetic, bupivacaine hydrochloride, was injected directly into the rat soleus muscle to cause myonecrosis. The regenerating fibers following necrosis were then examined by electron microscopy using lanthanum nitrate which clearly demonstrated the sarcotubular system. In the early stage of regeneration within 7 days after muscle necrosis, the T-tubules seemed to be composed of markedly proliferated subsarcolemmal caveolae with occasional honeycomb structure formation. Around 10 days, the T-tubules in regenerating fibers were tortuously and irregularly arranged with focal dilatation in diameter, and extended longitudinally along the axis of well organized myofibrils. As the regenerating fibers matured, the sarcotubular system, irregular in course and in shape, gradually became organized into a regular transverse position against the myofibrils, along with a marked decrease in longitudinally arranged tubular components. These morphological findings of the early T-tubule formation seen in the present study were similar to those found in early myogenesis, and in biopsied muscles from cases of polymyositis and progressive muscular dystrophy.

Animals↗

Maturational defect of regenerating muscle fibers in cases with Duchenne and congenital muscular dystrophies.

Immature fibers in Duchenne muscular dystrophy (DMD) and congenital muscular dystrophies (CMD) were compared with human fetal muscles and experimentally-induced regenerating muscle fibers using the acridine orange (AO) technique on fluorescent microscopy and histochemical methods. Strong AO activity was observed on immature fibers in dystrophies and on experimentally-induced fibers in the early stages of regeneration. These young fibers showed type 2C histochemical reactions on ATPase stains. Human fetal muscles failed to show these fibers which were seen in the muscular dystrophies and the experimental regenerating muscle. From these results it is concluded that immature fibers in muscular dystrophies are early stages of regenerating fibers and not maturationally arrested fetal muscle fibers. In addition, these immature fibers formed small groups composed of 10 to 50 fibers in muscular dystrophies and sometimes large groups in CMD. It is suggested that the investigation of immature fibers and their grouping is quite important for revealing the pathogenesis of the muscular dystrophies.

Acridine Orange↗

A fluorescent microscopy study of biopsied muscles from infantile neuromuscular disorders.

The Acridine Orange (AO) stain for muscle biopsies is particularly useful to identify regenerating and ongoing hypertrophic muscle fibers under fluorescent microscopy. This method was applied to muscle biopsies from 65 patients who suffered from various childhood neuromuscular disorders. While normal fibers showed dull green cytoplasm with small green-yellow nuclei, striking fluorescent fibers were observed in eight cases of congenital muscular dystrophy (CMD) and 12 cases of Duchenne muscular dystrophy (DMD); these fibers were characterized as follows: (1) small fibers with big oval or spherical nuclei which fluoresced strongly with a bright orange color; (2) fibers of various sizes and different degrees of orange fluorescence; and (3) opaque fibers with bright yellow cytoplasm. The small diameter fibers in Werdnig-Hoffmann (WH) disease, nemaline myopathy, and congenital fiber type disproportion failed to show apparent AO-RNA fluorescence. Although all the atrophic fibers in Kugelberg-Welander (KW) disease showed a vague orange fluorescent color, this was obviously different from that of regenerating fibers seen in CMD and DMD. In addition to these findings, the hypertrophic fibers in a case of unclassified myopathy also showed moderate orange fluorescence around the entire periphery of the cytoplasm.

Adolescent↗

Intracytoplasmic inclusions in the atrophic muscle fibers in Werdnig-Hoffmann disease.

In the biopsied muscle from a male infant having clinical and pathological characteristics of Werdnig-Hoffmann disease, unusual intracytoplasmic inclusions measuring from 1.5-7 micron in dimension were observed in approximately 3% of the atrophic fibers. Although the ultrastructural characteristics of the inclusion were almost identical to that of "cytoplasmic body" seen in various neuromuscular disorders, which showed somewhat different histochemical reactions. This unusual structure was assumed to have originated from degenerated myofibrils and possibly from mitochondria, while the significance of the body formation still remains to be solved.

Humans↗

Childhood-type myositis and linear scleroderma.

A 5-year-old girl had linear scleroderma on the flexor surface of the right arm; muscle wasting included the shoulder girdle. IgM fluorescence on blood vessels and along dermal-epidermal junction was observed by direct immunofluorescence in biopsied skin. Biceps muscle underlying the plaque of the scleroderma showed atrophy of entire fascicles, perifascicular atrophy, and cellular infiltration around blood vessels that are quite similar to those found in childhood-type dermatomyositis. In addition, various abnormalities, including edema and thickening of basal lamina, were found on blood vessels in muscle tissue. The results suggested that the autoimmune collagen vascular disorder is responsible for this condition.

Autoimmune Diseases↗

Glycogen storage myopathy with abnormal lactate dehydrogenase.

We studied a 3 year old girl with mental retardation and limb muscle weakness. The muscle glycogen content was 17.4 mg/g tissue, which was approximately three times higher than normal. There were no other known abnormalities noted in this child that could explain the cause of glycogen storage disease. Our in vitro glycolysis study showed marked increase of pyruvate, but no increase in lactate levels. The observed results suggested to us that an abnormal lactate dehydrogenase might account for the abnormal accumulation of glycogen in the muscle.

Child, Preschool↗