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Biomedical subjects

M Tsujihata

Publications and source records attributed to M Tsujihata.

At least 91 records · Page 5Linked to original sources

[A case of Rothmann-Makai syndrome associated with mononeuropathy].

We reported the first case of Rothmann-Makai syndrome associated with mononeuropathy in a 31-year-old woman. In June 1989, she noticed several small subcutaneous nodules in the bilateral upper arms. On July 2, she woke up because of severe pain below the knee in the right leg which lasted 15 hours. On admission, subcutaneous nodules were recognized on bilateral upper arms, abdomen, gluteal regions and thighs. None of these nodules were associated with local heat or pain. Muscle weakness and dysesthesia were observed in the right foot, but deep tendon reflexes were normal. Electrophysiological studies revealed a decrease of the amplitude of action potential and of the conduction velocity in the right tibial nerve. Microscopic examination of skin biopsy showed lipolysis and diffuse lymphocyte infiltration (panniculitis) and perivascular lymphocyte infiltration was also observed. Routine laboratory data including peripheral blood, ESR, blood chemistry, and CRP were in the normal range and antinuclear antibodies and LE cells were not detected. By those findings, she was diagnosed as Rothmann-Makai syndrome associated with mononeuropathy. Steroid treatment was effective on both skin lesions and mononeuropathy. Steroid treatment was effective on both skin lesions and mononeuropathy. We concluded that this mononeuropathy may be induced by a ischemic change which may be caused by panniculitis.

Adult↗

[Inverted papilloma of the renal pelvis].

A 60-year-old man with inverted papilloma of right renal pelvis is presented. On visit to hospital for benign prostatic hyperplasia with prostatic stone, he was found to have microscopic hematuria and intravenous pyelography and retrograde pyelography demonstrated a filling defect with papillary contour. We diagnosed a right renal pelvic tumor, which showed to be low grade because of negative cytology. Therefore, we performed tumor resection with renal preservation. Pathological diagnosis was inverted papilloma. From the Japanese and foreign literature, 16 cases of renal pelvic inverted papilloma were collected. They were reviewed clinically and pathologically, and the therapy was discussed.

Humans↗

[A case of inguinal bladder hernia].

Pyelocystography on a 61-year-old man with a ureteral stone incidentally revealed the inguinal bladder hernia. He had no complaint of urinary disturbances. During the operation for the hernia, we could not find the bladder without transurethral saline instillation; only the intestine covered with peritoneum was in sight. Utility of preoperative cystography on the cases of inguinal hernia is discussed.

Hernia, Inguinal↗

[A case of Crow-Fukase syndrome associated with idiopathic thrombocytopenic purpura].

A 40-year-old man was admitted to our hospital because of paresthesia and weakness of the limbs. At the age of 38, he was diagnosed as having an idiopathic thrombocytopenic purpura (ITP) which have been refractory to oral administration of prednisolone and splenectomy. Platelet-associated IgG was elevated markedly at that time. It was, however, only mildly elevated on this admission. He showed polyneuritis, generalized pigmentation, hirsutism, and marked edema on the legs. The bone X-ray disclosed a lytic lesion in the left iliac bone, which was confirmed as a plasmacytoma by bone biopsy. Axonal degeneration with marked loss of myelinated figure was seen on sural nerve biopsy. Serum immunoelectrophoresis revealed his monoclonal IgG was lambda type. Then, he was diagnosed as having a Crow-Fukase syndrome associated with ITP. Plasma exchange, pulse therapy, and irradiation to plasmacytoma resulted in a slight improvement of the polyneuritis and the skin symptoms, and a disappearance of edema. However, ITP has not responded to these therapies. Although the same autoimmune mechanism is suggested in these conditions, we could not clarify how this monoclonal IgG produce both polyneuritis and ITP.

Adult↗

[Study of antibodies to motor end-plate in ocular myasthenia gravis].

This study was undertaken to investigate whether serum obtained from ocular MG with undetectable antibodies contains antibodies which bind to normal motor end-plates immunohistochemically. Nineteen patients with ocular MG were studied. Anti-AChR antibodies in serum were assayed by an immunoprecipitation method using human junctional AChR as the antigen. Anti-AChR antibodies in serum which bind to the junctional AChR at the motor end-plates were detected immunohistochemically by incubating the muscle with each serum. Bound IgG was detected by peroxidase labeled protein A (P-PA). IgG deposit at the own limb muscle motor end-plates (biceps brachii) was also detected by P-PA. Anti-AChR antibodies in serum were positive in 9 out of 19 patients and IgG antibodies bound to the junctional AChR were demonstrated in 16 of 19 patients. IgG bound to own end-plates was observed in 13 of 14 patients studied. In 2 patients IgG was detected at the own end-plates, but not at the not-self end-plates. These findings indicate that detection of IgG at the limb muscle end-plates serves for the diagnosis of ocular MG with undetectable antibodies in serum and anti-AChR antibodies in some patients may react exclusively with the autologous AChR.

Adolescent↗

[A case of dural arteriovenous malformation in the region of the cavernous sinus improved by Matas procedure].

A 55-year-old woman developed the sudden onset of headache and diplopia. The neurological findings showed the left 3rd and 4th cranial nerve palsies, loss of pain and temperature sensation in the region innervated by the ophthalmic nerve, and bruit on the left orbit. The mixed type of dural arteriovenous malformation (AVM) in the region of the cavernous sinus was diagnosed by MRI and cerebral angiography. The Matas procedure in which the patient was guided to compress the cervical carotid artery herself for 10 minutes three times a day was performed. Neurological signs and symptoms disappeared completely 3 months after starting the Matas procedure, and MRI revealed the regression of AVM. These results suggest that Matas procedure may promote its spontaneous regression of dural AVM occurred in the region of the cavernous sinus.

Carotid Arteries↗

Retrovirus from human T-cell leukemia virus type I-associated myelopathy is the same strain as a prototype human T-cell leukemia virus type I.

A retrovirus was isolated from a T-cell line that was established from lymphocytes in the cerebrospinal fluid of a patient with human T-cell leukemia virus type I-associated myelopathy (HAM), and its genome was sequenced. The nucleotide sequence of the 3' half of the total genome was identical in 99.5% of the nucleotides to that of the prototype human T-cell leukemia virus type I that was derived from a patient with adult T-cell leukemia. These results indicate that the same retrovirus human T-cell leukemia virus type I is associated with both a neurological disease, HAM, and a lymphoproliferative disease, adult T-cell leukemia.

Amino Acid Sequence↗

[A case of hypothyroidism associated with hypokalemic periodic paralysis].

A case of hypothyroidism associated with hypokalemic periodic paralysis was reported. The patient, a 50 year-old female was admitted because of recurrent paralytic attacks. She had not presented any symptoms of hypothyroidism. Physical examination on admission revealed muscle weakness of limbs, but not enlargement of thyroid glands. Paralytic attack was induced by oral intake of 100 g of glucose, and during attacks, serum K levels ranged from 3.4 to 3.0 mEq/l. She was diagnosed chronic thyroiditis by the high level of TSH and thyroid related anti-antibodies in the serum. Muscle biopsy showed type II atrophy. After the improvement of thyroid function, her paralytic attack disappeared. Present study suggested that hypothyroidism could be a cause of hypokalemic periodic paralysis. This case was very rare and seemed important in etiology of periodic paralysis.

Chronic Disease↗

Characterization of HTLV-I in a T-cell line established from a patient with myelopathy.

We have established an interleukin 2-dependent, OKT4-positive T-cell line, named HCT-1, from cells in the cerebrospinal fluid obtained from a patient with human T-cell lymphotropic virus type I (HTLV-1)-associated myelopathy. Antigens for HTLV-I were detected in HCT-1 cells by indirect immunofluorescence and Western blot testing, and type C virus particles were detected by electron microscopy. Southern blot analysis of HCT-1 cellular DNA, using an HTLV-I probe, revealed that the integrated provirus genome could not be distinguished from the HTLV-I genome in adult patients with T-cell leukemia.

Blotting, Southern↗

Central motor conduction time in patients with HTLV-1 associated myelopathy.

Transcranial electrical stimulation of the motor cortex was performed in 7 patients with human T-lymphotropic virus type-I associated myelopathy (HAM) and 15 normal subjects. The mean value of central motor conduction time (CCT) for the thenar and hypothenar muscles in patients with HAM was not different from that in normal subjects. In contrast, mean CCT value for the tibialis anterior and gastrocnemius muscles in patients with HAM was 8.54-10.34 ms longer than the value in normal subjects. These findings indicate that the lesion of pyramidal tract involvement in patients with HAM is mainly localized in the descending corticomotoneuron pathways at the thoracic spinal cord level. This technique could be used in a clinical study without untoward side effects, and may be valuable in detecting clinically silent lesions involving the pyramidal tract.

Adult↗

Diagnostic significance of IgG, C3, and C9 at the limb muscle motor end-plate in minimal myasthenia gravis.

We detected deposits of IgG, C3, and C9 (immune complexes) at the limb muscle motor end-plates (biceps brachii muscle) in 16 of 19 patients who exhibited only ocular signs and symptoms of myasthenia gravis that were improved by intravenous injections of edrophonium chloride. Circulating anti-acetylcholine receptor (anti-AChR) antibodies were negative in 6 of the 16 patients, but the motor end-plate fine structure in the postsynaptic regions was abnormal in all 16. Single-fiber EMG revealed no abnormalities in 8 of 13 patients studied. Our results indicate that the detection of immune complexes at the limb muscle end-plate provides a highly sensitive and confirmative method for diagnosing patients with minimal or atypical myasthenia gravis who have no detectable anti-AChR antibodies in their serum.

Adolescent↗

Plasmapheresis in treatment of human T-lymphotropic virus type-I associated myelopathy.

In 11 of 18 patients with human T-lymphotropic virus type-I (HTLV-I) associated myelopathy (HAM) gait, sensory, and/or sphincter disturbance improved with plasmapheresis (4 to 6 sessions in 2 weeks), and the effects were maintained for 2 to 4 weeks. Plasmapheresis lowered the titre of HTLV-I antibody in serum but not in cerebrospinal fluid, and change of HTLV-I antibody titres did not correlate with the effects of plasmapheresis. These results suggest that plasmapheresis is useful treatment, at least in producing a temporary improvement, in patients with HAM, and that some humoral factor(s), but not HTLV-I antibody, may be important in the pathogenesis of HAM.

Adult↗

Resistance to ischemic conduction block of the peripheral nerve in hyperglycemic rats: an electrophysiological study.

Resistance to ischemic conduction block (RICB) was studied in rats with streptozotocin (STZ) induced hyperglycemia, hyperglycemia by glucose injection, and glycerin-induced hyperosmolarity. Ischemia was produced by tight ligation at the base of the tail. The time required for nerve action potentials (NAP) to disappear was defined as the disappearance time of NAP (DT-NAP). Both STZ and glucose rats showed a marked prolongation of DT-NAP at 2 hours after injection of STZ (up to 120 minutes) or glucose (up to 95 minutes), as compared with the control rats (less than 45 minutes). Hyperosmolar rats showed no prolongation of DT-NAP. The amplitude of NAP remained at the initial level for at least 2 hours after ligation of the sciatic nerve, whereas NAP disappeared within 45 minutes after ligation of the abdominal aorta. These findings indicate that the RICB can be produced by means of hyperglycemia without the presence of diabetic neuropathy and is the most sensitive indicator of hyperglycemia.

Action Potentials↗