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T Togashi

Publications and source records attributed to T Togashi.

At least 37 records · Page 2Linked to original sources

Measles virus-specific immunoglobulin G subclass response in serum and cerebrospinal fluid.

BACKGROUND: While many previous studies have focused on the impairment in the cellular immunity during measles virus infection, to date, a limited amount of data is available concerning the virus-specific IgG subclass response during measles virus infection. OBJECTIVE: The purpose of this study is to analyze the measles virus infection on the basis of virus-specific IgG subclass (G 1 and G 3). STUDY DESIGN: Frozen-stored, serum and/or cerebospinal fluid samples from three groups of patients were tested retrospectively; Group 1 comprised 14 patients with measles primary infection, group 2, ten patients with reinfection/vaccine failure, and group 3, seven patients with subacute sclerosing panencephalitis. The method used was a modified ELISA method utilizing the Enzygnost IgG detection kit with mouse-monoclonal antibodies (clone HP6091 for IgG 1 and clone HP6050 for IgG 3). Avidity testing for each subclass IgG was also performed for selected samples by means of an 8 M urea-denaturation method. RESULTS: In group 1, the IgG 3 could be detected in serum within 7 days from the onset of rash more frequently than IgG 1. In the cases of group 2, both subclasses were detected in very acute phase serum samples. In these cases, the IgG 1-specific avidity was always higher than that of IgG 3. In group 3, the subclass IgGs detected in the cerebrospinal fluid had a lower avidity than those in the serum. CONCLUSIONS: Our results suggested that in measles virus infection, like other viral infections, the IgG 3 response normally occurs before the IgG 1 response, and plays a major role in the acute phase immunity during the primary infection, while the IgG 1 plays a major role in the maintenance of immunity. Continuously produced IgG 1 and IgG 3 in the central nervous system in cases of subacute sclerosing panencephalitis may be derived from cell populations different from those in the blood.

Adolescent↗

[Acute encephalitis and encephalopathy at the height of influenza in childhood].

Twenty six infants and children with acute encephalitis and encephalopathy during two influenza seasons in Hokkaido, the northernmost island of Japan, were reported. Thirteen patients died and 5 had residual neurological sequelae. Influenza virus genome was detected by PCR in 9 out of 10 cerebrospinal fluid samples from these patients. CT and MRI of the brain demonstrated symmetrical changes in the thalamus and brainstem. The prevalence of these encephalitis and encephalopathy of childhood should be surveyed by nationwide scale.

Acute Disease↗

Survey of mycoplasmal bacteremia detected in children by polymerase chain reaction.

To determine whether mycoplasmal bacteremia occurs during ordinary or complicated diseases due to M. pneumoniae (and if so, how frequently), we used polymerase chain reaction (PCR) to detect M. pneumoniae in serum samples. The PCR primers used were modified for nested amplification. The genome of this organism was detected in 1 of the 25 patients with pneumonia and 10 of the 17 patients without pneumonia (P < .001, chi test). The genome was detected more frequently in patients who had encephalitis of which the neurological onset was within 7 days of the onset of fever rather than later. We hypothesize that mycoplasmal bacteremia occurs more frequently than previously appreciated, specifically in the absence of pneumonia, and that certain types of complications (e.g., encephalitis of early onset) are associated with its occurrence.

Adolescent↗

Immunoglobulin G avidity testing in serum and cerebrospinal fluid for analysis of measles virus infection.

We studied a variety of patients with measles virus infection by using avidity testing for measles virus-specific immunoglobulin G (IgG) in serum and cerebrospinal fluid samples. For the avidity testing, an Enzygnost measles IgG enzyme-linked immunosorbent assay kit was used with an 8 M urea denaturing method. With this method, low-avidity IgG (acute primary infection, avidity of < 30% within 15 days of the onset of rash) and high-avidity IgG (subacute sclerosing panencephalitis, avidity of > 75%) could be clearly distinguished by using serum samples. One patient, who developed a typical course of measles despite a previous vaccination, showed a positive IgM response with an initial low titer of measles virus-specific IgG of low avidity, but a later sample revealed a high titer of IgG of intermediate (40%) avidity, suggesting previous immunological priming. Two patients with breakthrough infection (secondary vaccine failure), both having central nervous system involvement, showed a positive IgM response with initial high titers of serum IgG of high avidity. In addition, one of the patients had a detectable level of measles-specific IgG in cerebrospinal fluid. In this patient, the avidity of both serum and cerebrospinal fluid IgG decreased during the short follow-up period. This phenomenon has never before been reported. In subacute sclerosing panencephalitis patients, the avidity of cerebrospinal fluid IgG was consistently lower than that of serum IgG. The difference in avidity between cerebrospinal fluid and serum IgG may be used as a direct indicator of intrathecal production of IgG. In conclusion, the avidity testing is simple to perform, reliable, and highly informative in the analysis of measles virus infection.

Adolescent↗

Pulmonary aspergillosis and pseudosequestration of the lung in chronic granulomatous disease.

We present a case of chronic granulomatous disease with an angiographically proven pseudosequestration of the lung. The patient was a 15-year-old boy who was admitted to the hospital with symptoms of fever, cough, hemoptysis and a subcutaneous abscess. Aspergillus fumigatus was isolated from the sputum and the abscess. During treatment, angiography demonstrated on anomalous blood supply to the right middle lobe. The therapeutic implications of pseudosequestration of the lung for the treatment of chronic granulomatous disease are discussed.

Adolescent↗

Measles encephalomyelitis in a patient with a history of vaccination.

Secondary vaccine failure (SVF) of measles is generally believed to run a milder course of illness than an ordinary course of infection. Severe complications such as central nervous system involvement have rarely been reported. A 12 year old girl, who had received a live attenuated measles vaccine 10 years earlier, developed an encephalomyelitis in the absence of symptoms indicative of ordinary measles such as Koplik spots. Anti-measles hemagglutination inhibition (HI) titer and measles IgM and IgG antibody titers were measured in a commercial laboratory. Measles virus genomic sequence was detected by polymerase chain reaction. Both serum and cerebrospinal fluid (CSF) samples obtained at acute phase already showed extremely high titers of HI (x8192 in serum and x1024 in CSF, respectively) and IgG antibody along with the presence of IgM antibody. Polymerase chain reaction detected the measles virus genomic sequence in the acute phase CSF. The patient's definite history of measles vaccination, high titers of HI and IgG antibodies observed at the very early stage of illness and the clinical course indicated that this patient has an encephalomyelitis due to SVF of measles. It is suggested that measles virus can be a pathogen of encephalitis without symptoms indicative of ordinary measles in individuals who received live attenuated measles vaccines.

Child↗

Interleukin-6 in cerebrospinal fluid of patients with central nervous system infections.

Interleukin(IL)-6 levels were measured in cerebrospinal fluid (CSF) and serum samples from pediatric patients with central nervous system (CNS) infections by means of an enzyme-linked immunosorbent assay. Mean IL-6 concentrations in CSF samples from patients with bacterial meningitis (49,017 +/- 44,730 pg/ml) were significantly higher than those in patients with aseptic meningitis (1076 +/- 1572 pg/ml) or encephalitis (409 +/- 835 pg/ml). In aseptic meningitis and encephalitis, IL-6 levels in serum were within the lower ranges (< 100 pg/ml), in contrast with the highly elevated levels found in bacterial meningitis (14,332 +/- 18,385 pg/ml). In 5 of the 15 patients with encephalitis, elevated levels of IL-6 were observed in the initial CSF samples despite normal findings of routine CSF examinations. Also, sequential CSF samples revealed that there was an increase in the CSF cell count in two of the five patients. These results validated the potential of measuring IL-6 in CSF samples for the purpose of providing additional information on routine laboratory test results.

Blood-Brain Barrier↗

Detection of measles virus from clinical samples using the polymerase chain reaction.

OBJECTIVE: To evaluate the usefulness of the polymerase chain reaction to detect the measles virus sequence using clinical samples. DESIGN: Centers for Disease Control and Prevention case definition of measles with or without IgM serology as a standard. SETTING: A laboratory in the Department of Pediatrics of the Hokkaido University Hospital, Sapporo, Japan. PATIENTS: Thirty-two serum samples, 16 throat swab samples, and nine cerebrospinal fluid samples from 32 patients with measles, including four patients with central nervous system involvement, and one serum sample and two throat swab samples from two patients with modified courses of measles were obtained. Ten serum samples, 10 throat swab samples, and 10 cerebrospinal fluid samples were obtained from patients without apparent measles infection as negative controls. MEASUREMENTS AND MAIN RESULTS: Sensitivity and specificity were comparable with those as obtained by culture or other methods reported in the literature. The polymerase chain reaction was positive in 24 (75.0%) of 32 by serum samples and in 13 (81.3%) of 16 by throat swab samples from the patients with measles, in contrast to none within the negative control group. In three of the four patients with central nervous system involvement, the measles virus sequence was detected in cerebrospinal fluid samples obtained within 1 day following the onset of the manifestations. All three samples from the patients with modified measles yielded positive results. CONCLUSIONS: The polymerase chain reaction can be used with sufficient sensitivity and specificity to detect the measles virus sequence using clinical samples. Transient and direct invasion of the central nervous system by this virus at the initial stage of the central nervous system involvement was strongly suggested.

Adolescent↗

[Nosocomial infections and infection control committee].

The problems of nosocomial infections include cross infections from the environments to patients in the wards and infections from virus-contaminated bloods into medical staffs by mainly needle stick injury. The infection control committees organized in Hokkaido University Hospital in 1981 for HBV infection, in 1992 for MRSA and HIV infections, provide adequate and urgent advice to all the medical staffs to prevent the spread of cross infections and to prevent the contaminations of blood-borne viruses. In this report, the present status of nosocomial infections especially the opportunistic infections in compromised hosts and the role of infection control committees were discussed.

Cross Infection↗

A rat model of human T lymphocyte virus type I (HTLV-I) infection. 1. Humoral antibody response, provirus integration, and HTLV-I-associated myelopathy/tropical spastic paraparesis-like myelopathy in seronegative HTLV-I carrier rats.

Human T lymphocyte virus type I (HTLV-I) can be transmitted into several inbred strains of newborn and adult rats by inoculating newly established HTLV-I-immortalized rat T cell lines or the human T cell line MT-2. The transmission efficiency exceeds 80%, regardless of strain differences or the age at transmission. The production of anti-HTLV-I antibodies significantly differs among the strains and depends on the age at the time of transmission. Rats neonatally inoculated with HTLV-I-positive rat or human cells generally become seronegative HTLV-I carriers throughout their lives, whereas adult rats inoculated with HTLV-I-positive cells at 16 wk of age become seropositive HTLV-I carriers. The HTLV-I provirus genome is present in almost all organs, regardless of whether the carriers are seronegative or seropositive. According to antibody titers to HTLV-I, there are three groups of inbred rat strains: ACI, F344, and SDJ (high responders); WKA, BUF, and LEJ (intermediate responders); and LEW (low responder). Three of three 16-mo-old seronegative HTLV-I carrier rats of the WKA strain developed spastic paraparesis of the hind legs. Neuropathological examinations revealed that the lesions were confined primarily to the lateral and anterior funiculi of the spinal cord. Both myelin and axons were extensively damaged in a symmetrical fashion, and infiltration with massive foamy macrophages was evident. The most severe lesions were at levels of the thoracic cord and continued from the cervical to the lumbar area. These histopathological features as well as clinical symptoms largely parallel findings in humans with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). These HTLV-I carrier rats, in particular the WKA rats described above, can serve as a useful animal model for investigating virus-host interactions in the etiopathogenesis of HTLV-I-related immunological diseases, particularly HAM/TSP.

Aging↗

Nested amplification protocol for the detection of Mycobacterium tuberculosis.

Several methods for rapid diagnosis of tuberculosis have been devised through DNA amplification. However, the chemically strong cell wall of the species, the presumptively low numbers of organisms and their uneven distribution in clinical samples, and the lack of a "gold standard" for diagnosing tuberculosis, have hindered the routine clinical use of this method. In a pediatric patient group, these factors are more perplexing. To circumvent these problems, we made use of nested amplification and developed a standard protocol for extracting DNA from various forms of clinical samples which were suitable to our clinical laboratory. It is our impression that the overall sensitivity, including technical bias accompanying this method, is equal to, or at least greater than, that of culture. Most notably, the rapidity in obtaining results and the simplicity in handling, storage and transfer of samples are the principal advantages of this method.

Arthritis, Infectious↗

Polymerase chain reaction for detection of Mycobacterium tuberculosis.

Rapid diagnosis of tuberculosis is essential, and therefore we use a polymerase chain reaction. In this report, we describe two cases of tuberculous lymphadenitis in childhood. Although histopathological findings were not specific for tuberculosis in both cases, distinct positive bands were amplified. For DNA diagnosis of tuberculosis, a lysis method of extracting chromosomal DNA from lipid-rich cell walls of mycobacteria is of critical importance. We made use of a simple lysozyme-proteinase K treatment for biopsied tissues. Although this extraction procedure was less efficient than those reported previously, it was considered sufficient for detecting mycobacterial DNA with the use of a highly sensitive polymerase chain reaction. We conclude that DNA amplification in combination with lysozyme lysis can be used routinely in clinical laboratories as a rapid and sensitive test for the diagnosis of tuberculosis.

Acute Disease↗