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Biomedical subjects

Manabu Tamura

Publications and source records attributed to Manabu Tamura.

18 recordsLinked to original sources
PubMed2006

Effects of probiotics on allergic rhinitis induced by Japanese cedar pollen: randomized double-blind, placebo-controlled clinical trial.

BACKGROUND: Lactobacillus casei strain Shirota (LcS) has been found to exert antiallergic effects in animal experiments, but there is little information about its clinical effects in human patients with allergy. METHODS: We performed a randomized double-blind, placebo-controlled study to investigate the effects of LcS in patients with allergic rhinitis triggered by Japanese cedar pollen (JCP). Participants were asked to drink fermented milk containing LcS (LcS group) or placebo (control group) for 8 weeks. Clinical symptoms and immunological parameters were compared between the two groups. RESULTS: Symptom-medication scores (SMS) worsened in accordance with the increase in the amount of scattered JCP. In terms of the nasal and ocular SMS, there was no significant difference between the LcS group and the placebo group during the ingestion period. In the subgroup of patients with moderate-to-severe nasal symptom scores before starting the ingestion of test samples, supplementation with LcS tended to reduce nasal SMS. CONCLUSION: These results indicate that fermented milk containing LcS does not prevent allergic symptoms in patients sensitive to JCP, but may delay the occurrence of allergic symptoms in patients with moderate-to-severe nasal symptom scores.

Adult↗
PubMed2006

Epilepsy related to hypothalamic hamartomas: surgical management with special reference to gamma knife surgery.

OBJECTIVE: A large spectrum of surgical techniques can be proposed to young patients presenting with hypothalamic hamartomas (HH) associated with severe epilepsy. The aim of this report is to point on some clinical and anatomical parameters supposed to influence the choice of the surgical approach and to emphasize the specific role of radiosurgery. MATERIALS AND METHODS: We reviewed both our experience and the recent literature based on a Pubmed search. Lateral pterional, midline frontal through the lamina terminalis, transcallosal interforniceal approaches, endoscopic treatment through the foramen of Monro, disconnecting surgery, radiofrequency ablation, brachytherapy and gamma knife surgery (GKS) were all considered. Mortality, morbidity, and efficacy of each of these techniques were compared. Specific limits, difficulties, and constraints were taken into account. Our experience of radiosurgery is based on a prospective trial which enrolled 60 patients with HH and associated severe epilepsy between October 1999 and December 2005. RESULTS: Several surgical techniques can lead to a real reversal of the epileptic encephalopathy. The main factors for the decision-making process are the age, the size of the lesion and its anatomical type (according to our original classification), the severity of the epilepsy, and the severity of the cognitive/psychiatric comorbidity. In our prospective trial (GKS), 27 patients have a follow-up superior to 3 years. Among those, 59.2% have an excellent result with a dramatic behavioral and cognitive improvement and are completely seizure-free (37%) or have only rare non-disabling seizures (22.2%). No permanent neurological complication has been observed so far; three patients have presented a transient poïkilothermia. GKS is clearly the safer approach for these difficult patients. Young patients with severe epilepsy and comorbidity must be operated on using a curative approach as early as possible. Very large type VI or mixed type with a large component above the floor of the third ventricle must be disconnected and then the upper remnant can be ideally treated by GKS (staged surgery). Type V (rarely epileptic) and IV are frequently operable by disconnection. Type I HH deeply embedded in the hypothalamus are operated on by GKS efficiently and safely. Type II HH can be operated on either endoscopically or transcallosally or by GKS depending on the parents' choice and severity of epilepsy. In small type III HH, GKS is a safer procedure, due to the very close relationship to the fornix and mammillary bodies. In very large type III HH, transcallosal interforniceal approach is proposed but with significant risks especially concerning short-term memory. When the lesion is sufficiently small, GKS is globally offering the patient a rate of seizure cessation comparable to microsurgery with, however, a much lower risk (no neurological deficit reported till now). CONCLUSION: Our first results indicate that GKS is as effective as microsurgical resection and very much safer. GKS also allows avoiding the vascular risk related to radiofrequency lesioning or stimulation. The disadvantage of radiosurgery is its delayed action. Longer follow-up is mandatory for a reliable evaluation of the role of GKS. The early effect on subclinical discharges turns out to play a major role in the dramatic improvement of sleep quality, behavior, and developmental learning acceleration at school.

Epilepsy↗
PubMed2006

The role of corticothalamic coupling in human temporal lobe epilepsy.

The EEG activity of the thalamus and temporal lobe structures (hippocampus, entorhinal cortex and neocortex) was obtained using intracerebral recordings (stereoelectroencephalography, SEEG) performed in patients with TLE seizures undergoing pre-surgical evaluation. Synchrony was studied using a statistical measure of SEEG signal interdependencies (non-linear correlation). The results demonstrated an overall increase of synchrony between the thalamus and temporal lobe structures during seizures. Moreover, although there was great inter-individual variability, we found that values from seizure onset period were significantly higher than values from the background period (P = 0.001). Values at the end of seizure were significantly higher than values from the seizure onset (P < 0.0001). Several indices were also defined in order to correlate some clinical features to the degree of coupling between cortical structures and the thalamus. In patients with mesial TLE seizures, a correlation was found between the degree of thalamocortical synchrony and the presence of an early loss of consciousness but not with other clinical parameters. In addition, surgical prognosis seemed better in patients with low values of thalamocortical couplings at the seizure onset. This report demonstrates that the thalamus and remote cortical structures synchronize their activity during TLE seizures and suggest that the extension of the epileptogenic network to the thalamus is a potential important factor determining surgical prognosis.

Adolescent↗
PubMed2006

Endolymphatic hydrops as a cause of audio-vestibular manifestations in relapsing polychondritis.

Relapsing polychondritis (RP) is characterized by inflammation and subsequent degeneration of cartilage. We report a 61-year-old woman who had RP with audio-vestibular manifestations. She was also diagnosed as having a myelofibrosis with myeloid metaplasia (MMM). Bilateral endolymphatic hydrops (EH) was confirmed by dominant -SP/AP of the electrocochleogram (ECochG). When thalidomide and prednisolone were prescribed for the treatment of MMM, symptoms of RP -- including the inner ear dysfunction -- were ameliorated. Isosorbide, one of the osmotic diuretics commonly used for the treatment of Meniere's disease (MD) in Japan, was also effective in keeping her free from inner ear dysfunction. This is the first report to confirm the existence of EH in a patient with RP with audio-vestibular manifestations. We suppose that an immunological imbalance due to MMM, in conjunction with a specific immunogenetic background, may have played a role in the pathogenesis of RP and the formation of EH in this patient.

Acute Disease↗
PubMed2005

Requirement for CD100-CD72 interactions in fine-tuning of B-cell antigen receptor signaling and homeostatic maintenance of the B-cell compartment.

Co-receptors on the B-cell surface regulate B-cell antigen receptor (BCR) signaling; however, it remains unclear how BCR signals are coordinated to maintain immune homeostasis. CD72, a negative regulator of B-cell responses, has immunoreceptor tyrosine-based inhibitory motifs within its cytoplasmic region, and the tyrosine phosphatase SHP-1 binds these sites. The natural ligand of CD72, CD100/Sema4D, belongs to the semaphorin family and induces the dissociation of SHP-1 from CD72, thereby switching off the negative signals of CD72. In the absence of CD100, BCR signals are significantly suppressed due to the constitutive association of SHP-1 with CD72, resulting in B-cell hyporesponsiveness. Here we show that CD100 regulates the sensitivity of the BCR by preventing the association of the CD72 with BCR, and this interaction is required for proper B-cell homeostasis. Consequently, as CD100-deficient mice age, they accumulate marginal zone B cells and develop high auto-antibody levels and autoimmunity. Collectively, our findings indicate that the strength of BCR signals is strictly tuned by the interaction of CD100 with CD72, and this interaction is essential for maintaining immunological homeostasis as well as generating a proper immune response.

Animals↗
PubMed2005

Outcome of gamma knife radiosurgery in 82 patients with acromegaly: correlation with initial hypersecretion.

CONTEXT: Because surgical and medical therapies of acromegaly all have specific limitations, radiotherapy has been used as an adjunctive strategy. Stereotactic radiosurgery has not yet been widely evaluated. OBJECTIVE: The objective was to perform an analysis of long-term hormonal effects and tolerance of gamma knife radiosurgery. DESIGN: Eighty-two patients were prospectively studied over a decade, with a mean follow-up of 49.5 months. SETTING: All patients were treated at the Department of Functional Neurosurgery of Marseille, France. PATIENTS: The patients included 82 with active acromegaly, of whom 63 had previous transsphenoidal surgery. INTERVENTION: Intervention included radiosurgery using the Leksell Gamma Unit B model. MAIN OUTCOME MEASURES: Remission was diagnosed when mean GH levels were less than 2 ng/ml and IGF-I was normal for age off somatostatin agonists (at least 3 months). RESULTS: Seventeen percent of the patients were in remission without any treatment. Twenty-three percent previously uncontrolled on somatostatin agonists fulfilled the same criteria after gamma knife while maintained on medical treatment. Initial GH and IGF-I levels off somatostatin agonists were significantly higher in uncured than in remission group (P = 0.01 and 0.047, respectively). Withdrawal of somatostatin agonists at the time of radiosurgery had no incidence on the outcome. No significant difference was found in success rate whether patients had previously been treated or not. Long-term side effects included complete (n = 2) or partial (n = 12) hypopituitarism diagnosed 1-7 yr after gamma knife. CONCLUSIONS: Gamma knife radiosurgery may represent a therapeutic approach in patients with moderate initial or residual GH hypersecretion.

Acromegaly↗
PubMed2005

Nonredundant roles of Sema4A in the immune system: defective T cell priming and Th1/Th2 regulation in Sema4A-deficient mice.

The class IV semaphorin Sema4A provides a costimulatory signal to T cells. To investigate the possible developmental and regulatory roles of Sema4A in vivo, we generated Sema4A-deficient mice. Although Sema4A-deficient mice develop normally, DCs and T cells from knockout mice display poor allostimulatory activities and T helper cell (Th) differentiation, respectively. Interestingly, in addition to its expression on DCs, Sema4A is upregulated on Th1-differentiating cells, and it is necessary for in vitro Th1 differentiation and T-bet expression. Consequently, in vivo antigen-specific T cell priming and antibody responses against T cell-dependent antigens are impaired in the mutant mice. Additionally, Sema4A-deficient mice exhibit defective Th1 responses. Furthermore, reconstitution studies with antigen-pulsed DCs reveal that DC-derived Sema4A is important for T cell priming, while T cell-derived Sema4A is involved in developing Th1 responses. Collectively, these results indicate a nonredundant role of Sema4A not only in T cell priming, but also in the regulation of Th1/Th2 responses.

Animals↗
PubMed2005

"Sulcal root" generic model: a hypothesis to overcome the variability of the human cortex folding patterns.

The great variability of cerebral cortical folding patterns raises major problems for the systematic study of functional-structural relationships. This paper describes a novel perspective for explaining this variability, a perspective that relies on gyri buried in the depth of the sulci. From this perspective we propose a generic model of folding, based on indivisible units, called sulcal roots, which correspond to the first folding locations during antenatal life. These units are organized according to a basic scheme allowing us to describe the cortical surface using a system of meridians and parallels. This scheme is thought to be stable across individuals at the fetal stage, and may be related to the protomap model. Variability at the adult stage is thought to result from the chaotic behavior of the folding process: inter-individual differences in cortical areas can lead to qualitatively different folding patterns. We have tested the capacity of this model to match actual cortical anatomy with a database of magnetic resonance images of 20 normal subjects, using new three-dimensional visualization tools giving access to shapes buried in the cortex.

Adult↗
PubMed2004

IgA class switch occurs in the organized nasopharynx- and gut-associated lymphoid tissue, but not in the diffuse lamina propria of airways and gut.

Secretory IgA plays a crucial role in the host immune response as a first line of defense. A recent demonstration of in situ IgA class switching in intestinal lamina propria provided an opportunity to reconsider the model for the homing of IgA-committed B cells characterized by distinctive trafficking patterns to effector sites. Those effector sites depend on the organized mucosa-associated lymphoid tissues as their site of induction. In this report we show the preferential presence of IgM(+)B220(+) and IgA(+)B220(+) cells belonging to pre- and post-IgA isotype class-switched cells in the organized mucosa-associated lymphoid tissues, such as nasopharynx-associated lymphoid tissues, isolated lymphoid follicles, and Peyer's patches, and the defect of those populations in the diffuse effector tissues, such as the nasal passage and intestinal lamina propria. Consistent with these findings, the expressions of a series of IgA isotype class switch recombination-related molecules, including activation-induced cytidine deaminase, Ialpha-C micro circle transcripts, and Ialpha-C micro circle transcripts, were selectively detected in these organized mucosa-associated lymphoid structures, but not in the diffuse mucosal effector sites. Taken together, these findings suggest that IgA isotype class switching occurs only in the organized mucosa-associated lymphoid organs (e.g., nasopharynx-associated lymphoid tissues, isolated lymphoid follicles, and Peyer's patches), but not in the diffuse effector tissues of the upper respiratory and gastrointestinal tracts.

Animals↗
PubMed2004

Histological observation of complete closure of anterior capsulotomy in 2 cases.

We report the histological finding of complete closure of the anterior capsulotomy window in 2 cases. The cases were successfully treated with surgery after neodymium:YAG laser anterior capsulotomy failed. Histology and immunohistochemistry were performed to determine the pathogenesis. Histology revealed the presence of elongated, fibroblast-like lens epithelial cells in association with extracellular matrix accumulation, which were positive for collagen types, fibronectin, and osteopontin. The cells were labeled with anti-alpha-smooth muscle actin antibody. The finding indicates that phenotypic modulation in lens epithelial cell to contractile cell type and accumulation of matrix are involved in closure of the anterior capsulotomy window.

Aged↗
PubMed2004

Protective effect of montmorillonite on plasmid DNA in oral gene delivery into small intestine.

Montmorillonite, a bioinert clay mineral, was examined as a novel vector for an oral gene-delivery system. The complex of montmorillonite and plasmid DNA encoding the enhanced green fluorescent protein (EGFP) gene was prepared at various weight ratios, and then transfected into cultured intestinal epithelial cells (IEC-6) in vitro. The EGFP gene was clearly transcribed when the transfection was performed using the montmorillonite-plasmid complex at a weight ratio of 0.05:1. In contrast, no gene expression was detected by reverse transcription-polymerase chain reaction (RT-PCR) analysis when the transfection was performed with naked plasmid. Various plasmid preparations were given orally to mice, and the gene expression in the stomach and small intestine was examined by RT-PCR. Although no gene expression was detected in the mice receiving an oral administration of naked plasmid or polyethyleneimine-plasmid complex, the EGFP gene complexed with montmorillonite was expressed in the small intestine. These results indicate that montmorillonite protected the plasmid DNA from the acidic environment in the stomach and DNA-degrading enzymes in the intestine, and successfully delivered it into cells of the small intestine.

Administration, Oral↗
PubMed2003

The alteration of odor-induced c-Fos immunoreactivity in the rat olfactory bulb after olfactory nerve transection.

We used the rats in which one olfactory nerve had been transected and observed the odor (Propionic acid) -induced c-Fos immunoreactivity in the bulb at different times (2, 4, 8 weeks) after nerve transection. The exposure to odor produced a strong cluster of c-Fos positive cells in the mediodorsal region of the intact bulb. On the other hand, the transected bulb showed much less reactivity 2 weeks after neurectomy; however, a large number of positive cells were observed in the whole of the bulb from 4 weeks after neurectomy. Furthermore, we measured the levels of mRNA for tyrosine hydroxylase (TH), which was the marker of odor-induced olfactory nerve activity in the bulb, by using real-time PCR. The level of TH mRNA decreased on the transected side at 2 weeks but recovered to the level of the contralateral side at 4 weeks after neurectomy. We firstly demonstrated that projection mapping of odor receptors was altered after olfactory nerve transection by using an immunohistochemical method.

Animals↗
PubMed2003

Evaluation of provocation test monitoring palmoplantar temperature with the use of thermography for diagnosis of focal tonsillar infection in palmoplantar pustulosis.

BACKGROUND: Since focal tonsillar infections are often associated with palmoplantar pustulosis (PPP), provocation tests have been performed for preoperative evaluation of tonsillectomy. However, these tests have not been fully established. OBJECTIVES: To introduce a more sensitive operative indication for tonsillectomy to the patients with PPP, we have monitored the temperature after provocation tests at palmoplantar sites, as measured by thermography, and we hypothesized that this methodology may lead to a more sensitive marker for tonsillectomy. METHODS: Twenty-two PPP patients with/without clinical tonsillitis were included in this study. After mechanical tonsillar massage, using infrared thermography, we have monitored the surface temperature at palmoplantar sites of 22 patients with PPP, five chronic tonsillitis patients without PPP, and four healthy controls, to compare the findings with the skin lesional outcome after tonsillectomy. RESULTS: There was a significant relationship between the effects of tonsillectomy and the results of provocation tests assessed by thermography. The sensitivity, specificity, and efficiency of the provocation tests with thermography of detecting a favorable outcome of tonsillectomy were 75.0, 83.3, and 77.3%, respectively, while those of the provocation tests as estimated with the conventional criteria were 37.5, 83.3, and 50.0%, respectively. CONCLUSION: Our results suggest that a new indicator using non-invasive thermography for the provocation tests is useful in predicting the effects of tonsillectomy for PPP.

Adult↗
PubMed2003

Modulation of T-cell functions by laser surgery in patients with allergic rhinitis.

OBJECTIVE: Potassium-titanyl-phosphate (KTP) laser turbinectomy is an established treatment for hypertrophied inferior turbinates that do not respond to other medical treatments. KTP laser surgery is usually performed with the aim of reducing the size of hypertrophied inferior turbinates. We hypothesized that laser vaporation may also inhibit the allergic reaction in the nasal mucosa of inferior turbinates. MATERIAL AND METHODS: We examined the effect of KTP laser therapy on T-cell responses using peripheral blood mononuclear cells (PBMCs). RESULTS: Levels of T-cell proliferation after stimulation with Staphylococcus enterotoxin B (SEB) were higher in post- than pre-surgery patients. Levels of interferon-gamma and IL-2 produced by PBMCs after stimulation with SEB appeared to be higher in post- than pre-surgery patients. Serum levels of house dust-specific IgE were lower in post- than pre-surgery patients. These results indicate that KTP laser therapy modulates T-cell responses and probably tilts the Th1/Th2 balance towards the Th1-dominant state. CONCLUSION: KTP laser surgery eases or cures allergic rhinitis not only by reducing the volume of the inferior turbinates but also by modulating T-cell functions.

Adolescent↗
PubMed2003

Distant metastasis of dermatofibrosarcoma protuberans of the scalp--case report.

A 49-year-old man presented with a rare dermatofibrosarcoma protuberans (DFSP) of the scalp associated with local recurrence and distant metastasis to the lung and abdomen. An elastic-hard small mass on the right occipital scalp was initially treated by simple resection in another clinic. Ten years later, recurrent tumor was associated with infiltration to the calvarium, and resection was performed again also in another clinic. Approximately 1.5 years later, the patient was transferred to our clinic because of recurrence with intracranial involvement. Repeated relapses and metastasis to the lung were recognized despite surgery, chemotherapy, and local radiation. Eventually, the patient died of distant metastasis to the abdomen 17 years after the initial diagnosis. Scalp DFSP is very uncommon but is an aggressive scalp tumor, so initial wide local resection and local radiation therapy after surgery are important to prevent local recurrence and distant metastasis.

Abdominal Neoplasms↗
PubMed2002

Three-dimensional analysis of human locomotion in normal subjects and patients with vestibular deficiency.

The purpose of this study was to clarify the role of the vestibular system in human locomotion. The subjects were nine healthy controls, nine patients with unilateral vestibular deficiency (UVD) and nine patients with bilateral vestibular deficiency (BVD). The UVD subjects were Ménière's disease patients who were being treated with administration of gentamicin into the tympanic cavity. BVD subjects were hearing-impaired individuals who showed no response to the ice-water caloric test. A total of 13 markers were attached to the head, trunk (C7), hip and foot in order to measure translational and rotational motions with the aid of a video image processing system. All subjects were instructed to restrict their stride length to approximately 80 cm while walking on a treadmill and watching a visual target. However, walking speed varied depending on the ability of the subject to maintain body equilibrium. The results showed that walking speed and step frequency were significantly lower for the UVD and BVD groups than for the normal group. Analysis of head movements in the sagittal plane showed a counteracting motion between pitch rotations and vertical translation as previously reported. We also found head counteracting motions between yaw rotation and lateral translation in the horizontal plane. These mechanisms are thought to help stabilize the gaze during walking. When the head fixation point was calculated by projecting the naso-occipital axis line during walking, the head counteracting motion was found to assist the vestibulo-ocular reflex in stabilizing the gaze. In addition, normal subjects seemed to use head stabilization as a space strategy in order to minimize head yaw movement. In contrast, UVD and BVD subjects adopted head stabilization as a trunk strategy.

Case-Control Studies↗
PubMed2002

Ultrasonography in a nasal cavity filled with water during endoscopic sinus surgery.

We developed a new ultrasonographic imaging technique to be used in a water-filled nasal cavity during endoscopic sinus surgery, and estimated how well surgically dangerous sites were depicted. Our newly developed balloon can completely fill the choana, preventing water from leaking into the pharynx. The balloon enables endoscopic sinus surgery to be relatively safely performed in "flowing water." Fifteen patients with chronic sinusitis underwent endoscopic sinus surgery under local anesthesia, and a MicroTip Radial probe was inserted into the water-filled nasal cavity. The orbital contents, skull base, and maxillary sinuses were visualized in all cases. Even in cases with a thin lamina papyracea, the boundary of the orbit could be judged from the motion of the orbital contents. Ultrasound information obtained in real time will be useful for improving the safety of endoscopic sinus surgery. Our ultrasonographic imaging technique can provide an early warning to the surgeon and thereby prevent severe complications.

Endoscopy↗