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Biomedical subjects

K Hashimoto

Publications and source records attributed to K Hashimoto.

At least 559 records · Page 31Linked to original sources
PubMed1998

Collagenofibrotic glomerulonephropathy associated with immune complex deposits.

A 66-year-old Japanese male, who suffered from persistent proteinuria and leg edema, underwent renal biopsy. Light microscopy revealed marked narrowing of the glomerular capillary lumen with a diffuse accumulation of weakly PAS-positive material. By electron microscopy, abundant abnormal collagen fibers were observed predominantly in the subendothelial space and occasionally in the mesangial matrix. The fibers had a periodicity of about 60 nm and were immunoreactive for anti-type III collagen. Subendothelial electron-dense deposits were also found in some of the capillary walls. The serum level of procollagen III peptides was elevated and changed in parallel with the amount of proteinuria during the patient's clinical course. On the basis of these findings, a diagnosis of the collagenofibrotic glomerulonephropathy was made. A review of the literature, including 29 similar or identical cases, failed to reveal the etiology and pathogenesis of this disease. We suggest that this disease may be divided into two different clinical subtypes, an adult-onset type and a pediatric type.

Aged↗
PubMed1998

Superantigen production by Staphylococcus aureus in psoriasis.

BACKGROUND: Activation of T cells is believed to play a critical role in the pathogenesis of psoriasis. Recently, it has been proposed that psoriasis is a T-cell-mediated autoimmune reaction triggered by bacterial superantigen. OBJECTIVE: We investigated whether patients with chronic plaque psoriasis bear superantigen-producing Staphylococcus aureus on the skin or the throat. METHODS: S. aureus producing exfoliative toxin, staphylococcal enterotoxin B or toxic shock syndrome toxin 1 was isolated from the skin and throat of 100 psoriasis patients using Western blot analysis and polymerase chain reaction. RESULTS: Only 5, 4 and 9 patients had super-antigen producing S. aureus identified on lesional skin, nonlesional skin and throat, respectively. The vast majority of patients did not bear superantigen-producing S. aureus. CONCLUSION: We believe that superantigens are not essential in sustaining disease activity but may, instead, be exacerbating or triggering factors for some psoriasis patients.

Adolescent↗
PubMed1998

Stimulation of the preprothyrotropin-releasing hormone gene by epidermal growth factor.

Regulation of the expression of the prepro-TRH (ppTRH) gene by epidermal growth factor (EGF) was investigated. The i.p. injection of EGF significantly stimulated hypothalamic ppTRH messenger RNA levels in rats. To clarify whether this stimulatory effect of EGF could be exerted at the level of gene transcription, the 5'-flanking region (-1893/+127) of the mouse ppTRH gene fused to a luciferase reporter gene was transiently transfected into pituitary GH4C1 cells, and the effect of EGF on gene transcription was measured by a luciferase assay. EGF stimulated ppTRH gene promoter activity in a time- and dose-dependent manner. Deletion analysis revealed that two different regions of the promoter, between -254 and -218 [EGF response element-1 (EGFRE1)] and between -130 and -84 (EGFRE2) were required for full stimulation by EGF. The two EGFREs possessed putative binding sequences for the transcription factor Sp1, and they functioned cooperatively in heterologous promoters. Nuclear extracts from GH4C1 cells specifically bound those two EGFREs in gel retardation assays. Two protein-DNA complexes were found on EGFRE1, whereas four complexes were observed on EGFRE2. Although the binding of nuclear extracts to EGFRE1 was competed for by the consensus Sp1 binding sequence, the complexes on EGFRE1 were not supershifted by an Sp1 antibody. Formation of the slower migrating protein complex on EGFRE1 was prevented by EDTA, suggesting that one of the EGFRE1-binding proteins might be an Sp1-related zinc finger protein. Competition and supershift experiments demonstrated that the EGFRE2-binding protein showing that the slowest migration possessed a characteristic similar to that of Sp1. Selective mutations of the Sp1-binding site in EGFRE2 markedly diminished the EGF-induced stimulation. These results suggest that EGF may function as a positive regulator of ppTRH gene expression, and that the stimulatory effect may be mediated through a cooperative interaction between Sp1 or Sp1-related proteins and additional factors that bind to two separate DNA regions.

Animals↗
PubMed1998

Left coronary artery-left ventricle fistula with right coronary artery spasm.

A 72-year-old woman was admitted to our hospital for evaluation of chest pain. Coronary angiography showed a left coronary artery-left ventricle fistula. An acetylcholine provocation test induced vasoconstriction of the right but not the left coronary artery. Her chest pain was not relieved by combined therapy with isosorbide dinitrate, diltiazem and nicorandil. Because of the coronary spasm, beta-blockers could not be used. However, her chest pain was relieved after the administration of a minor tranquilizer. Thus, the patient's chest pain was unlikely to be associated with either the fistula or the coronary spasm.

Acetylcholine↗
PubMed1998

Affinity of antioxidative polyphenols for lipid bilayers evaluated with a liposome system.

We developed a method to measure the amounts of antioxidative polyphenols and ubiquinones incorporated into the liquid bilayers of liposomes to estimate their affinities for cell membranes. Results were expressed in terms of an "affinity factor", calculated by division of the amount of compound incorporated by the amount added to the liposomal solution. The results reflected dose-dependence of the biological activities of the compound found in earlier in vitro experiments with mammalian and bacterial cells.

Animals↗
PubMed1998

Effects of beta-lactoglobulin on the tight-junctional stability of Caco-2-SF monolayer.

The mechanisms for tight-junction (TJ) stabilization by beta-lactoglobulin (beta-Lg) were studied. Treatment of Caco-2-SF cells with inhibitors for some enzymes in the intracellular signal transduction pathways and a cytoskeleton-disturbing agent (cytochalasin D) reduced the TJ-stabilizing activity of beta-Lg. So beta-Lg is suggested to modulate the cytoskeletal structure through the activation of phospholipase C and protein kinase C, resulting in the TJ stabilization.

Animals↗
PubMed1998

[Association analysis of angiotensin-converting enzyme gene polymorphism with end-stage renal disease].

BACKGROUND: Intron 16 insertion/deletion (I/D) polymorphism in the angiotensin-converting enzyme (ACE) gene may be associated with the progression of renal insufficiency in patients with renal diseases. The objective of this study was to determine whether D allele is a risk factor for the progression of the disease in end-stage renal disease (ESRD) patients. METHODS: Using PCR techniques, genetic analysis of the ACE I/D polymorphism was performed on 326 dialysis patients. We compared the distribution of genotypes and allele frequency of this polymorphism in dialysis patients and the normal Japanese population. The clinical courses of 47 patients were studied retrospectively, and the progression of chronic renal failure using time plots of the reciprocal of serum creatinine (1/Cr) was estimated. RESULTS AND CONCLUSION: The frequencies for II, ID, and DD genotypes were 134, 148 and 44, respectively. The frequency for I allele was 0.64, and for D allele 0.36. These results were similar to the frequencies found in the normal Japanese population. However, patients with polycystic kidney disease (PKD) showed a high frequency for D allele (0.54: p = 0.023 by chi 2 method). In longitudinal courses, we did not find any association between ACE gene polymorphism and the declining rate of renal function. However, in patients with PKD, the DD genotype may influence the clinical course of renal disease.

Adult↗
PubMed1998

A case of Gitelman's syndrome with chondrocalcinosis.

A 45-year-old Japanese woman, treated for Bartter's syndrome for 14 years, presented with complaints of numbness in her extremities and polyarthralgia. She was diagnosed to have Gitelman's syndrome with chondrocalcinosis, which were effectively treated with spironolactone and magnesium supplementation. Gitelman's syndrome is a primary renal tubular disorder characterized by hypomagnesemia and hypocalciuria with normal calcemia. The persistent hypomagnesemia is one of the causes of chondrocalcinosis, and many cases of Bartter's syndrome with hypomagnesemia are associated with chondrocalcinosis attributed to a tubular magnesium defect. We summarize the reported cases with Bartter's syndrome and chondrocalcinosis, referring to the possibility of Gitelman's syndrome.

Bartter Syndrome↗
PubMed1998

Severe diabetic scleredema with extension to the extremities and effective treatment using prostaglandin E1.

We report a 49-year-old woman with severe diabetic scleredema (DS). The patient had non-insulin-dependent diabetes mellitus (NIDDM) for 9 years and noticed thickened skin on her back 3 years previously. Her DS rapidly extended to her back and extremities with pain and immobility. Her symptoms of DS improved dramatically after establishing strict glycemic control and intravenous administration of prostaglandin E1 (PGE1). However, the histological findings of her skin biopsy did not change even after the treatment for 12 weeks, and her symptoms worsened again after discontinuation of glycemic control and PGE1 treatment. The causes of DS have been considered to be metabolic abnormalities associated with hyperglycemia and hypoxia in the skin due to diabetic microangiopathy. PGE1 was an effective treatment for DS in our patient. Strict control of hyperglycemia and PGE1 treatment may be sufficient to manage DS, although a very long treatment period is necessary.

Acupuncture Analgesia↗
PubMed1998

Subependymoma in the lateral ventricle incidentally detected by routine brain examination--case report.

A 42-year-old male visited our hospital for a routine brain examination, which incidentally identified an intraventricular mass lesion (2.7 x 1.6 x 1.2 cm3). Magnetic resonance imaging showed the tumor was isointense on the T1-weighted image and hyperintense on the T2-weighted and proton images. The intraventricular tumor was totally extirpated through the interhemispheric ipsilateral transcallosal approach. The histological diagnosis was subependymoma. Neuroimaging cannot differentiate this benign neoplasm from other more aggressive tumors. Widespread use of the medical checkup system is expected to find a higher incidence of otherwise non-identified asymptomatic lesions. Surgical extirpation is one of the treatment options to establish the correct diagnosis and to prevent symptoms.

Adult↗
PubMed1998

[A case of pityriasis rubra pilaris associated with unclassified connective tissue disease and sepsis in clinical course].

The patient was a 23-year-old woman with HTLV-I carrier and was diagnosed as pityriasis rubra pilaris soon after her birth. In November 1990 at her age of 16, she began to have fever and polyarthralgia which were not improved despite the administration of antibiotics. Her laboratory findings showed the positive antinuclear antibody and anti-RNP antibody suggesting one of collagen diseases. A tentative diagnosis as unclassified connective tissue disease (UCTD) was made since her symptoms and laboratory findings were not satisfied with any criteria for rheumatic disorders. The steroid therapy was started in February 1991 and showed a good response. On April 9th, 1996, however, she was admitted to our hospital because of recurrence of high fever and chills. This time, she had sepsis because of the evidence that Enterococcus faecalis was detected in blood culture. Although her condition was improved by antibiotics on June 4th 1996, high fever re-appeared and followed by convulsion and disseminated intravascular coagulation. After the doses of prednisolone per day was increased to 40 mg with antibiotics and anticoagulant, her condition gradually improved. This patient was a rare case of pityriasis rubra pilaris associated with UCTD and sepsis in clinical course.

Adult↗
PubMed1998

[Peripheral neuropathy and dysautonomia in a patient with primary Sjögren's syndrome].

A 46 year-old female presented with dry eyes and a dry mouth which she had been experiencing for about 15 years. She also began to notice dizziness (orthostatic hypotension) during the last 5 years. The symptoms gradually increased whereupon she began to have polyarthralgia, facial flashing, hyper and hyposweating in some areas on the face and trunk. Her sialography showed a damaged parotid gland. Minor salivary gland biopsy revealed chronic sialoadenitis. The Sirmer test was low, and the Rosebengal test indicated keratoconjunctivitis sicca. Her serological tests showed hypocomplementemia and were positive for antinuclear antibody and SS-A antibody. The diagnosis of primary Sjögren's syndrome (SjS) was made based on these findings. Prednisolone, at a dose of 15 mg per day, was given orally. As a result of this therapy, arthralgia disappeared immediately, although it had no effect on the neuropathy found in this patient. This is a rare case of SjS associated with peripheral neuropathy and severe dysautonomia.

Autonomic Nervous System Diseases↗
PubMed1998

[MPO-ANCA related diffuse alveolar hemorrhage].

The purpose of this study was to elucidate the clinical features characterizing patients with myeloperoxidase specific-antineutrophil cytoplasmic antibody (MPO-ANCA) related diffuse alveolar hemorrhage (DAH). Seventeen MPO-ANCA-positive patients were evaluated. Nine patients (52.9%) had pulmonary involvement; of those, 6 (35.3%) had DAH, and 4 (23.5%) had interstitial pneumonia (1 patient had both pulmonary diseases). Three of the patients with DAH demonstrated only mildly bloody sputum. All patients with DAH had increased peripheral white blood cell counts, high titers of C-reactive protein and MPO-ANCA, and marked microscopic hematuria. DAH was diagnosed in all cases by fiberoptic bronchoscopy with bronchoalveolar lavage. All patients with DAH were treated with three pulses of methylprednisolone, and 5 were treated with cyclophosphamide. Three of the patients with DAH required mechanical ventilation for respiratory insufficiency, but 2 were relieved of that need by immunosuppressive therapy. In spite of intensive care, 1 patient died of respiratory failure and 2 died of complications related to therapy. The prognosis for patients with DAH is poor. We emphasize the importance of prompt and accurate diagnoses and aggressive care, including immunosuppressive therapy, mechanical ventilation, and hemodialysis. In addition, extra precautions should be taken against opportunistic infections such as Pneumocystis carinii pneumonia.

Aged↗
PubMed1998

[Infective endocarditis associated with ruptured aneurysm of Valsalva: aortic valve replacement after reconstruction of left ventricular outflow tract].

Infective endocarditis associated with ruptured aneurysm of Valsalva disrupted the vicinity of aortic annulus (Valsalva, valve, left ventricular outflow tract). This condition did not accept insertion of prosthetic valve at normal position. Insertion of St. Jude valve was performed after the reconstruction of outflow tract with a xenopericardial patch. Proportionate sutures for the right cusp part was taken through the infundibular muscle at the right ventricular side, not in the pericardial patch. The bileaflet valve functioned properly in spite of the oblique insertion.

Adult↗
PubMed1998

[An experience with peeling technique with curettage of open mitral commissurotomy].

Ideally, the mitral valve is a soft, thin and flexible tissue. In severe rheumatic mitral stenosis, however, its motion is restricted due to the adhesion of fibrous tissues and calcium. Open mitral commissurotomy was not effective in successfully restoring it to normal condition. By using a peeling technique with curettage during open mitral commissurotomy, the calcium and fibrous tissues are sufficiently removed. This method is effective in improving the flexibility of the anterior leaflet of the restricted mitral valve.

Cardiac Surgical Procedures↗