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Biomedical subjects

Y Aihara

Publications and source records attributed to Y Aihara.

At least 91 records · Page 5Linked to original sources

[Detection of IgE antibodies to salt-insoluble wheat proteins in sera of patients with atopic dermatitis by ELISA and immunoblotting techniques].

Specific IgE antibodies against salt-insoluble wheat proteins were investigated in sera from 60 patients with atopic dermatitis (AD) positive to wheat specific CAP-RAST. The salt-insoluble wheat protein fraction was prepared from whole protein fraction of wheat flour, which was extracted by PBS containing 6 M urea. IgE antibodies to salt-insoluble proteins were detected in 15 of the sera. IgE-ELISA was applied to these 15 sera, with whole wheat proteins, salt-soluble proteins, and salt-insoluble proteins used as antigens. Wheat specific CAP-RAST values correlated well with the IgE-ELISA titers against salt-soluble proteins (r = 0.918 p < 0.001). On the other hand, IgE-ELISA titers against both the salt-insoluble proteins and the whole wheat proteins correlated least with CAP-RAST values (r = 0.161 and r = 0.113). The inhibition tests indicated that IgE antibodies against salt-insoluble proteins were different from those against salt-soluble ones. Thus, IgE antibodies to salt-insoluble proteins were another antigen target of IgE-mediated allergy manifestation. To determine the molecular weight of antigens reacting with IgE, IgE-immunoblotting was performed. Several polypeptides with molecular weights of 33-45, 84, 90 and 98 KD were detected. However, the antigen patterns of the blots varied depending on the sera used. These findings suggest that salt-insoluble wheat proteins are the major antigens in some wheat-dependent AD, and that IgE detection against salt-insoluble wheat proteins is important for the diagnosis of wheat allergy.

Adolescent↗

Acute leucoencephalopathy during cyclosporin A therapy in a patient with nephrotic syndrome.

A 13-year-old girl with nephrotic syndrome (NS) developed acute leucoencephalopathy during combination therapy with cyclosporin A (CyA) and prednisolone (PSL). The patient had a generalized motor seizure followed by coma at 19 days after CyA administration. Magnetic resonance scanning performed on the 1st hospital day revealed white matter lesions in the subcortices of the parietal and occipital lobes, brain stem and cerebellum. These lesions had completely resolved on the 10th hospital day. This episode might be caused by CyA because the clinical course and laboratory data revealed neither inflammation nor other causative factors. To our knowledge, this is the first report of acute leucoencephalopathy during combination therapy with CyA and PSL in a patient with NS.

Acute Disease↗

Comparison of wasting syndrome in [MRL lpr/lpr-->MRL +/+] chimera and graft versus host disease in [B10.D2-->BALB/c] chimera and an attempt to transfer the wasting syndrome in [MRL lpr/lpr-->MRL +/+] to MRL +/+ mice.

We compared the findings in the wasting syndrome seen in [MRL lpr/lpr--> MRL +/+] chimeras with those of chronic graft versus host disease (GVHD) in [B10.D2-->BALB/c] chimeras. BALB/c mice were lethally irradiated and administered B10.D2 spleen and bone marrow cells. These mice are identical to MHC and Mls but differ as to genetic background. As a result of chronic GVHD, these [B10.D2-->BALB/c] chimeras showed hair loss, weight loss and atrophy of lymph nodes and spleen beginning 5 weeks after the transplantation. MRL lpr/lpr mice carry the lpr gene and spontaneously develop generalized lymph node swelling and lupus-like autoimmune disease, while congenic MRL +/+ mice lack the lpr gene. The [MRL lpr/lpr-->MRL +/+] chimeras showed wasting and the same symptoms as in [B10.D2-BALB/c] chimeras beginning 16 weeks after cell transfer. Skin biopsy from both chimeras showed very similar changes on HE staining and on immunoperoxidase staining for Ia and Thy-1. Our data suggest that very small differences in minor histocompatibility may induce GVHD which produces severe wasting with lethal consequences. Finally, we succeeded in transferring the wasting syndrome seen in the [MRL lpr/lpr--> MRL +/+] chimera to other MRL +/+ mice by transplanting spleen cells from the [MRL lpr/lpr-->MRL +/+] chimera to lethally irradiated MRL +/+ mice.

Alopecia↗

[Analysis of children with tuberculosis in recent 10 years].

To make an early diagnosis and decision for prompt treatment of the children with tuberculosis, we analyzed 61 cases in both inpatients and outpatients for the clinical and laboratory characteristics. One fourth of the 61 cases were below 1-year-old, and 43 cases (70.5%) had a positive family history. The tuberculin test revealed that all of the 61 cases were positive, and 18 of them had a strongly positive reaction (> or = 30 mm). Although the serum levels of inflammatory markers including white blood cells counts, erythrocyte sedimentation rate and CRP value increased only slightly in most cases, serum IgM levels in 59.0% of the children with tuberculosis were twice to three times higher than those in normal average levels. Especially in 96.2% of the children hospitalized for the need of isolation the IgM levels were demonstrated high. Thus, in children with tuberculosis the detection of serum IgM levels as well as family history, tuberculin reaction, and chest X-ray findings may be helpful for the early diagnosis and prompt decision of hospitalization.

Adolescent↗

[A case of juvenile dermatomyositis with calcinosis universalis--remarkable improvement with aluminum hydroxide therapy].

Juvenile dermatomyositis (JDM) is a multisystem disease characterized by acute and chronic nonsuppurative inflammation of striated muscle and skin. JDM is classified into an independent entity in the classification of dermatomyositis, and it is marked by the development of calcinosis late in the course of the disease. Since an appropriate steroid therapy for the disease was established, the prognosis of the JDM has been improved except for a fulminant case. Frequency of calcinosis in JDM also has been decreasing because of the adequate steroid therapy. However, once calcinosis universalis occurs, this is the most troublesome and debilitating complication in JDM. Treatment of calcinosis universalis in JDM, so far, remains unsatisfactory. We report here a case of JDM, who suffered from at the age of 3 years, with calcinosis universalis that showed remarkable improvement to orally administrated aluminum hydroxide.

Adolescent↗

[Thermographic assessment of Raynaud's phenomenon in childhood mixed connective tissue disease].

To assess Raynaud's phenomenon objectively, thermographic estimation of hands and fingers was performed before and after the disease- and Raynaud's phenomenon-directed therapy in 3 children with mixed connective tissue disease. All the cases were positive in Raynaud's phenomenon, and the surface temperature of their hands and fingers were decreased even before cold challenge. After the cold provocation test at 4 degrees C for 10 sec., the temperature of all or some of the fingers were rapidly decreased, and the recovery of surface temperature of these fingers were markedly delayed. Even after methylprednisolone pulse therapy the pattern of the finger temperature were essentially unchanged, suggesting that steroids are not effective in the treatment of Raynaud's phenomenon. The long-term administration of vitamin-E, oral prostaglandin E1, and/or serotonin-receptor inhibitor were also proved to be not beneficial in improving Raynaud's phenomenon. Thus, thermography is useful in diagnosing Raynaud's phenomenon objectively, in determining the efficacy of anti-Raynaud drugs, and in estimating long-term course of the phenomenon.

Adolescent↗

[Familial Behçet's disease--a case report].

We reported a case of mother and child affected with Behçet's disease. Both had recurrent oral ulcer, erythema nodosum and arthralgia. Neither had gastrointestinal manifestation nor central nervous system involvement. The mother represented positive pathergy test, but the child did not. Laboratory data suggested no severe sign of inflammatory reaction and increased levels of immunoglobulin D. She was diagnosed as incomplete form, and he was diagnosed as suspicious form of Behçet's disease. On HLA examination, they had common haplotypes of HLA A24, B61, Cw1 and DR8. Additionally, haplotypes of HLA B7, Cw7, DR1, DQ1, were also detected in the mother, and HLA A2, Cw3, DR12, in the child. HLA-B51, which is primarily associated with Behçet's disease, was failed to be demonstrated. Familial involvement of Behçet's disease were described in only 20 cases, 11 of which had positive HLA B51. These findings suggest that molecular genetic examinations for both class I and II antigens will be necessary for a case of familial involvement.

Adult↗

[A case of agammaglobulinemia with chronic progressive encephalopathy].

We report a 21-year-old man with agammaglobulinemia and chronic progressive encephalopathy. The patient was diagnosed as having X-linked agammaglobulinemia at 6 months of age, and gamma globulin supplementation was initiated. He exhibited normal development until he was 11 years old, when he showed a decline in school performance and a personality change. Computed tomography images at that time disclosed diffuse cerebral atrophy. Several generalized tonic-clonic convulsions, myoclonus and spasticity appeared at the age of 13 years. He lost his ability to walk and speak at the age of 17 years old. He is currently 21 years old and displays severe mental deterioration and spastic tetraplegia. Magnetic resonance imaging showed progressive diffuse cerebral atrophy with no change in intensity. The cerebellum and the brain stem were relatively well maintained. Viral isolations were negative and serum antibody titers for rubella, measles, and human immune deficiency virus were not elevated. Our patient's symptoms resemble those previously reported as chronic progressive encephalopathy without viral isolation. This condition may be a complication of agammaglobulinemia. It is possible that the encephalopathy of our patient has the same etiology as that described in the other reports. Further attempts to identify the etiology of the encephalopathy using molecular techniques are necessary.

Adult↗

[Evaluation of serum C3 and CH50 levels as markers of disease-activity and indicators of efficacy of treatment of lupus nephritis in childhood].

Serum levels of complement components (C3 and C4) and its activity (CH50) were analysed in 20 children with lupus nephritis from view points of disease-activity and efficacy of therapy. After the initiation of prednisolone or methylprednisolone pulse therapy for children in active phases the depressed C3 and CH50 levels were rapidly recovered to normal ranges within 4 months and 2 months, respectively. On the contrary serum C4 levels were normalized later in 11 months. Increased levels of antinuclear antibody and anti-DNA antibody titers have reciprocally dropped in response to those therapy. However, in 9 of 20 children the titers of antinuclear antibody and anti-DNA antibody remained high. Proteinuria observed in active phases of lupus nephritis has disappeared by therapy in all but two exceptions: these two children were complicated with nephrotic syndrome. Histological improvement after therapy was not observed (WHO classification). These findings suggested that it is useful to monitor serum C3 and CH50 levels but not C4 levels to judge disease-activity, and to evaluate efficacy of therapy of lupus nephritis in childhood.

Adolescent↗

[Behçet's disease in childhood--case reports and review of literature].

Two childhood with Behcet's disease were reported. To evaluate the clinical features of Behcet's disease in childhood, fifty eight case studies (domestic; 19 cases, world-wide; 39 cases) were examined from the literature including two cases in our clinics. Oral ulcers (100%), genital ulcers (82.8%), skin manifestations (77.6%), and articular involvement (51.7%) were frequently found as seen in adult cases. Gastrointestinal manifestations were more common in childhood than in adults (50.0% vs. 29.3%). However, ocular inflammatory disease was less frequently seen in pediatric patients as opposed to adults. Three fourth of children with Behçet's disease was effectively treated with oral or intravenous prednisolone. These findings suggested that the criteria for childhood Behçet's disease will be necessary for early and proper diagnosis.

Behcet Syndrome↗

[Effects of combined administration of prednisolone and mizoribine in the course of remission for SLE children with nephritis].

Since oral steroid therapy was introduced for SLE, the long-term prognosis of the patients has been significantly improved. Adverse effects of the drug, however, are inevitable for these patients. The characteristic of the adverse effects especially for the child case is the suppression of linear growth. In order to prevent these undesirable effects and to improve their quality of life (QOL), we had introduced the methylprednisolone pulse therapy for SLE in children as both an initial and a relapse therapy. Although this therapy improved QOL of the patients significantly, there was little benefit for the growth disturbance. Then, we have introduced Mizoribine in addition to prednisolone (PSL) therapy for more than 18 months in three SLE children with lupus nephritis. In this trial, the combination therapy was effective for the decrease of urinary protein in one case, and for the reduction of a dosage of oral PSL in one case. In other case, MZR showed only partial immunosuppression. Thus, we concluded that there was a limitation with this combination therapy, however, it is one of the worthy therapy to be tried in SLE children with nephritis.

Adolescent↗

Presence in Kawasaki disease of antibodies to mycobacterial heat-shock protein HSP65 and autoantibodies to epitopes of human HSP65 cognate antigen.

The central features of Kawasaki disease are immune activation and cytokine-mediated generalized vasculitis. To identify the predisposing factors, we examined the antibody response to BCG antigens, since reactivation of a previous BCG inoculation site is an early, specific manifestation of this disease. BCG antigens were separated on SDS-PAGE, transferred to membrane, and incubated with acute- and convalescent-phase sera of 21 patients with Kawasaki disease. Sera were also examined for the presence of antibodies to mycobacterial 65-kDa heat-shock protein (HSP65), and to its human homolog P1 antigen using synthetic peptides of nonhomologous region. To demonstrate the HSP65-sensitized T cells, in vitro proliferation assay was performed. All convalescent, but not acute phase, sera showed a strong antibody reactivity against 65-kDa protein. The reactivity was directed to recombinant HSP65. Non-cross-reactive sequences between rHSP65 and human HSP65 cognate were synthesized. The sera recognized these peptides of rHSP65 and autologous P1 antigen. Peripheral lymphocytes proliferated following the addition of rHSP65 (stimulation indices, 2.16-7.82; mean, 4.54). These findings suggest that HSP65 may be the most potent factor predisposing to Kawasaki disease, and that an autoreactivity to the epitope of the human HSP65 homolog may be related to the susceptibility to the disease.

Amino Acid Sequence↗

[OKN and OKAN induced by stripe and random dot patterns].

The velocity storage mechanism in optokinetic nystagmus (OKN) was studied in 50 healthy adults. We used stepwise stimulations generated by projecting stripe and numerous random dot patterns on a screen at 20, 40, 60 and 80 deg/sec. The slow-phase OKN velocity followed stripe and random dot patterns almost immediately after the onset of the stimuli at 20 deg/sec. On the other hand, it tended to gradually increase after the onset of stimuli at 60 or 80 deg/sec. This gradual increase in slow-phase eye velocity has also been observed in several animal species, such as the monkey and cat. The slow-phase velocity of the first OKAN beat was higher with the random dot pattern than with the stripe pattern regardless of stimulation velocity. The above findings indicate that OKN in man is mediated through direct and also indirect pathways as observed in animals. With random dot pattern stimulation, particularly, the indirect pathway seems to perform an important role in generating OKN and OKAN.

Adolescent↗

Expression of multidrug resistance gene mdr1 mRNA in a subset of normal bone marrow cells.

The multidrug resistance gene mdr1, encoding P-glycoprotein (P-gp), can be expressed at high levels in tumour cells derived from normal tissues with constitutive high expression of this gene. In myelogenous leukaemia, the incidence of increased expression of mdr1 gene contrasts with the low expression of this gene in normal bone marrow (b.m.). To detect cells expressing mdr1 gene in normal and post-chemotherapy b.m., we used in situ RNA hybridization and RNA phenotyping by the polymerase chain reaction for mdr1 mRNA detection. The presence of P-gp was evaluated by immunocytochemistry with MRK16. Fifteen b.m. (eight normal and seven post chemotherapy) were tested by in situ hybridization and either PCR (three b.m.) or immunocytochemistry (11 b.m.) or both (one b.m.). With in situ mRNA hybridization, a subset (7.7% +/- 3.1%) of b.m. cells expressed mdr1 mRNA in all cases tested, with no significant differences between normal b.m. and post chemotherapy b.m. 18% of myeloid recognizable cells and 7% of the cells with lymphoid morphology expressed mdr1 mRNA. By RNA phenotyping, the four samples tested for in situ hybridization and two additional post chemotherapy b.m. expressed mdr1. MRK16 was unable to detect a significant number of cells expressing P-gp either by immunocytochemistry in the 12 b.m. tested for in situ hybridization (0% in nine cases; 0.4%, 1% and 3% of positive cells in three cases), or by flow cytometry in six additional normal b.m. (0-1.4% positive cells).

ATP Binding Cassette Transporter, Subfamily B, Mem↗

[Effect and limitation of intravenous methylprednisolone pulse therapy in the long-term follow-up of childhood systemic lupus erythematosus].

The course of 6 patients with childhood systemic lupus erythematosus was analysed with emphasis on the effect and limitation of intravenous methylprednisolone pulse therapy in the long-term follow-up. The present findings suggest that using pulse therapy within 2 months in the course of disease flares, probably before irreversible organ damage has occurred, may be more beneficial in suppressing the disease activity and maintaining long-term remission. The demonstration of low serum complement activity (CH 50), and in some cases, proteinuria, was useful to decide the time of pulse therapy. Complications of pulse methylprednisolone plus long-term oral prednisolone therapy included cushingoid appearance and low body height in addition to cataract and glaucoma, all of which were attributable not to methylprednisolone pulse therapy alone but to long-term accumulation of corticosteroids. The combination therapy including several immunosuppressants needs to be established in order to avoid these steroidal complications.

Administration, Oral↗

A combined approach for purging multidrug-resistant leukemic cell lines in bone marrow using a monoclonal antibody and chemotherapy.

Selective removal of malignant cells (purging) from bone marrow (BM) is a concern in autologous BM transplantation (ABMT). Use of vincristine, etoposide, or doxorubicin for purging could be rendered ineffective by the presence of multidrug-resistant (MDR) tumor cells. To circumvent this particular problem, we investigated whether 17F9, a monoclonal IgG2b antibody directed against the cell surface product of the MDR gene, P-glycoprotein, is effective in selective removal of MDR cells from BM when used with rabbit complement (C'). Using two different cell lines we have demonstrated that 17F9 + C' selectively lyses MDR-positive cells. Three rounds of antibody + C' resulted in 96.4% +/- 3.6% kill of K562/DOX and 100% +/- 0% of CEM/VLB cells. Mixtures of malignant cells and normal BM resulted in 99.85% removal of K562/DOX and 99.91% removal of CEM/VLB clonogenic cells. This treatment did not affect normal committed precursors compared with C' alone. The addition of the cytotoxic agent etoposide (VP-16) following antibody purging results in a 4.6 log reduction of malignant cells. Furthermore, this antibody was effective when used against patients' leukemic blasts. These results suggest the use of 17F9 + C' is effective and selective for removal of MDR cells from BM before ABMT and the addition of VP-16 enhances the purging efficacy.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Demonstration of mother-to-infant transmission of hepatitis B virus by means of polymerase chain reaction.

To investigate the failure of vaccines to prevent mother-to-infant transmission of hepatitis B virus (HBV), serum, cord blood, and colostrum samples from eleven mothers, known to be carriers of hepatitis B surface antigen, and their infants were examined by means of a highly sensitive polymerase chain reaction (PCR) method. HBV-specific DNA was detected in ten maternal serum samples, eight samples of colostral whey, eight samples of colostral cells, and one cord blood sample. Four infants of mothers with HBV-DNA-positive colostrum showed low responsiveness to hepatitis B vaccine. The infant whose cord blood was positive for HBV DNA showed low responsiveness to hepatitis B vaccine and subsequently became an HBV carrier. These results suggest the need for further study to evaluate whether breastfeeding is advisable for HBV carriers.

Carrier State↗