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Takeshi Matsuyama

Publications and source records attributed to Takeshi Matsuyama.

17 recordsLinked to original sources
PubMed2007

Effects of phytosterols in diacylglycerol as part of diet therapy on hyperlipidemia in children.

BACKGROUND: The incidence of hyperlipidemia in children is increasing in Japan, but drug therapy for such children is limited. The ingestion of 4% phytosterols-containing diacylglycerol (PS/DAG) decreases serum total cholesterol and low density lipoprotein cholesterol (LDL-C) concentrations in adults. In the present study, we examined the effect of PS/DAG as part of a diet therapy in pediatric patients with hyperlipidemia. METHODS: Pediatric patients with hyperlipidemia with > or =5.18mmol (200 mg/dL) serum total cholesterol and/or >or =1.70mmol (150 mg/dL) triglycerides (N=22) ingested bread containing PS/DAG (total daily intake, 10g) for 6 months. Blood chemistry was examined prior to and 2, 4, 6 months after the initiation of ingestion, and 4 months after the ingestion period. RESULTS: No significant differences in energy intake or cholesterol intake during the study period were found. After 4 months of ingestion of PS/DAG, LDL-C, lipoprotein(a) [ Lp(a)], free fatty acids and total ketone bodies decreased significantly. In seven patients with familial hypercholesterolemia, total cholesterol and remnant-like lipoprotein particles (RLP)-cholesterol also significantly decreased in addition to LDL-C and Lp(a). CONCLUSIONS: PS/DAG improves serum lipid metabolism in pediatric patients with hyperlipidemia for whom drug therapy is limited, suggesting that PS/DAG may reduce the risk of developing various diseases induced by hyperlipidemia.

Adolescent↗
PubMed2006

Magnetic resonance images in hanging.

Hanging is a devastating method of suicide and unfortunately is common in Japan. Although several CT findings of the head have been reported, there have not been any reports about magnetic resonance imaging (MRI) in hanging. We report here interesting MRI findings in a patient after hanging. A 39-year-old woman was transferred to our department after attempting suicide by hanging. Respiration had probably ceased for about three minutes but heart had not stopped when she was pulled down by her father. After her father performed cardiopulmonary resuscitation, she started to breathe immediately. She was treated conservatively in our intensive care unit for 14 days, her condition became stable. Ten days after admission, MRI demonstrated symmetrical hyperintensity on T1-weighted images and relative hyperintensity on T2 weighted images in bilateral lentiform nuclei and medial thalami. There have been several reports about characteristic MRI findings in the case of acute global cerebral ischaemia caused by severe hypoglycaemia or longstanding cardiopulmonary arrest. It was postulated that these specific findings reflected tissue degeneration, deposition of mineral substances, or lipid accumulation. These MRI findings suggest that severe acute global cerebral hypoperfusion also occurs in hanging in the same way as in long-standing cardiopulmonary arrest and that hanging has devastating sequelae.

Adult↗
PubMed2006

Effects of diacylglycerol oil on adiposity in obese children: initial communication.

Several studies have shown that diacylglycerol (DAG) oil may suppress accumulation of body fat in adults compared to triacylglycerol (TAG) oil. In this study, we investigated the effect of DAG oil as part of dietetic therapy in obese children. The participants were 11 male and female obese children who were under treatment at the outpatient clinic (four boys, seven girls, age: 7-17 years old). Daily-use cooking oil was changed to DAG oil, and the effects on abdominal fat areas, adipocytokines, and serum lipids were investigated. The total and subcutaneous fat areas significantly decreased in the 5th month after ingestion of DAG oil. Leptin was significantly lower than the initial level after ingestion of DAG oil. The ingestion of DAG oil decreased both the abdominal fat area and leptin in obese children, suggesting that DAG oil prevents obesity in children as well as in adults.

Abdominal Fat↗
PubMed2006

Perimesencephalic nonaneurysmal subarachnoid hemorrhage caused by physical exertion.

The clinical characteristics of perimesencephalic nonaneurysmal subarachnoid hemorrhage (SAH) caused by physical exertion were analyzed to investigate the causes and mechanisms of perimesencephalic nonaneurysmal SAH. Nine of 209 patients with spontaneous SAH were identified as having perimesencephalic nonaneurysmal SAH. Perimesencephalic nonaneurysmal SAH in four males and three females was precipitated by exertion. Age, sex predominance, type of exertion, symptoms, loss of consciousness during bleeding, clinical grade, angiographic spasm, hydrocephalus, delayed ischemic deficit, rebleeding, hypertension, and outcome were evaluated in these seven patients. Outcomes were assessed using the Glasgow Outcome Scale. Patients showed male predominance (57.1%), relatively young age (mean 50 years), low frequency of hypertension (28.6%), good clinical grade (World Federation of Neurological Surgeons grade I or II), and excellent outcomes including no rebleeding, no symptomatic hydrocephalus, and no delayed ischemic deficits. The type of exertion was swimming in two patients, golfing in two patients, heavy lifting in two patients, and bending forward during gymnastics in one patient. Physical exertion including components of the Valsalva maneuver is an important predisposing factor for perimesencephalic nonaneurysmal SAH. Such physical exertion produces increased intrathoracic pressure, which blocks the internal jugular venous return, resulting in elevated intracranial venous pressure or mechanical swelling of the intracranial veins, and leads to venous or capillary breakdown.

Adult↗
PubMed2004

The W258X mutation in SLC22A12 is the predominant cause of Japanese renal hypouricemia.

Recently, a urate transporter, hURAT1 (human uric acid transporter 1) encoded by SLC22A12, was isolated from the human kidney. hURAT1 is presumed to play the central role in reabsorption of urate from glomerular filtrate. In the present study, we analyzed SLC22A12 in seven unrelated Japanese patients with renal hypouricemia whose serum level of urate was less than 1.0 mg/dl, and their family members. We performed direct DNA sequencing of the exon and exon-intron boundaries of SLC22A12 using genomic DNA. Six of the seven patients (86%) possess mutations in SLC22A12. In five patients, a homozygous G to A transition at nucleotide 774 within exon 4 of SLC22A12, which forms a stop codon (TGA) at codon 258 (TGG), was identified (W258X). In one patient, the C to T transition within exon 3, which changes threonine at codon 217 to methionine (T217 M), and the W258X mutation were found (compound heterozygote). Thus, among 12 mutational alleles in six patients, 11 were the W258 X mutation (92%). Family members with the heterozygous W258X mutation (carriers) show relatively low levels of serum urate. The present study demonstrates that homozygous W258X mutation is the predominant genetic cause of idiopathic renal hypouricemia in Japanese patients.

Adolescent↗
PubMed2004

Prognostic factors in hanging injuries.

The objectives of this study were to review variable factors influencing outcomes in hanging and to identify prognostic factors related to outcomes. Forty-seven patients presented to our department. Eleven patients survived and 36 died. A significant difference in mean hanging time was observed between survivor (11.8 +/- 8.37 minutes) and nonsurvivor (50.81 +/- 61.9). In survivors, heartbeat was recognized in 63.6% at the scene and in 90.9% on arrival. Conversely, cardiopulmonary arrest (CPA) was recognized in all nonsurvivors and heartbeat was recognized on arrival in only 5.6%. Thirty-nine (83%) had a Glasgow Coma Score (GCS) of 3 on arrival. Three (7.7%) of theses 39 patients survived. In survivors, eight patients had a GCS greater than 3. A significant difference in outcome existed between patients with a GCS of 3 and those with a GCS greater than 3. Hanging time, presence of CPA at the scene and on arrival, and GCS on arrival represented prognostic factors of outcome in hanging.

Adolescent↗
PubMed2004

Typical MPGN with few urinary abnormalities.

We describe the concurrent appearance of membranoproliferative glomerulonephritis (MPGN) in renal biopsy samples and normal urinary sediment without hematuria, proteinuria, or renal dysfunction in 1 child and asymptomatic microscopic hematuria without significant proteinuria or renal dysfunction in 2 children who were subsequently followed up for many years. The only other abnormality detected was hypocomplementemia. This is the first report of biopsy-proven typical MPGN in patients with few urinary abnormalities. A renal biopsy should be considered in children with hypocomplementemia, regardless of urinalysis findings, to exclude MPGN.

Biopsy↗
PubMed2004

Chemokine expression in nerve allografts.

OBJECTIVE: Chemokines (chemoattractant cytokines) play a major role in trafficking of cells to areas of inflammation. Infiltration of allograft tissues by immunocompetent cells is critical for rejection of donor tissues. The role of chemokines in nerve allograft rejection is not clear. We hypothesized that chemokines are responsible for attracting macrophages and T lymphocytes into nerve allograft tissue, initiating the graft rejection process. METHODS: Lewis rats received 4-cm-long peroneal nerve allografts and isografts from ACI and Lewis rats, respectively. Twelve hours to 10 days after transplantation, grafts were removed and total cellular ribonucleic acid was extracted. Intragraft gene expression of several chemokines (cytokine-induced neutrophil chemoattractant, macrophage inflammatory protein [MIP]-2, monocyte chemoattractant protein-1, MIP-1 alpha, and regulated upon activation normal T-cell expressed and secreted [RANTES]) were analyzed by reverse transcription-polymerase chain reaction. RESULTS: The cytokine-induced neutrophil chemoattractant was expressed in allografts and isografts at early time points (12 h to 6 d). Monocyte chemoattractant protein-1 messenger ribonucleic acid expression was similarly high in both isografts and allografts from 12 hours until 8 days after transplantation. MIP-1 alpha, MIP-2, and RANTES were expressed only in allografts. Kinetics of the neutrophil (MIP-2) and macrophage (MIP-1 alpha) chemokines revealed an early onset (12-24 h), a plateau from 1 to 4 days, and expression abruptly declining by Day 6. The lymphocyte chemoattractant RANTES had delayed kinetics, with a rise at Day 3, a peak at Day 4, and a gradual decline. CONCLUSION: Induction of specific chemokine genes precedes nerve allograft infiltration by immunocompetent cells. MIP-1 alpha, MIP-2, and RANTES may be responsible for recruiting macrophages, granulocytes, and lymphocytes, respectively, to the rejecting allograft. In future studies, blockade of these specific chemokines or their receptors may prove to delay or prevent nerve allograft rejection.

Animals↗
PubMed2002

Chronic Schwann cell denervation and the presence of a sensory nerve reduce motor axonal regeneration.

Motor axonal regeneration is compromised by chronic distal nerve stump denervation, induced by delayed repair or prolonged regeneration distance, suggesting that the pathway for regeneration is progressively impaired with time and/or distance. In the present experiments, we tested the impacts of (i) chronic distal sensory nerve stump denervation on axonal regeneration and (ii) sensory or motor innervation of a nerve graft on the ability of motoneurons to regenerate their axons from the opposite end of the graft. Using the motor and sensory branches of rat femoral nerve and application of neuroanatomical tracers, we evaluated the numbers of regenerated femoral motoneurons and nerve fibers when motoneurons regenerated (i) into freshly cut and 2-month chronically denervated distal sensory nerve stump, (ii) alone into a 4-cm-long distally ligated sensory autograft (MGL) and, (iii) concurrently as sensory (MGS) or motor (MGM) nerves regenerated into the same autograft from the opposite end. We found that all (315 +/- 24: mean +/- SE) the femoral motoneurons regenerated into a freshly cut distal sensory nerve stump as compared to 254 +/- 20 after 2 months of chronic denervation. Under the MGL condition, 151 +/- 5 motoneurons regenerated, which was not significantly different from the MGM group (134 +/- 13) but was significantly reduced to 99 +/- 2 in the MGS group (P < 0.05). The number of regenerated nerve fibers was 1522 +/- 81 in the MGL group, 888 +/- 18 in the MGM group, and 516 +/- 44 in the MGS group, although the high number of nerve fibers in the MGL group was due partly to the elaboration of multiple sprouts. Nerve fiber number and myelination were reduced in the MGS group and increased in the MGM group. These results demonstrate that both chronic denervation and the presence of sensory nerve axons reduced desired motor axonal regeneration into sensory pathways. A common mechanism may involve reduced responsiveness of sensory Schwann cells within the nerve graft or chronically denervated distal nerve stump to regenerating motor axons. The findings confirm that motor regeneration is optimized by avoiding even short-term denervation. They also imply that repairing pure motor nerves (without their cutaneous sensory components) to distal nerve stumps should be considered clinically when motor recovery is the main desired outcome.

Animals↗
PubMed2002

The single-plasma-sample method for determining the glomerular filtration rate with Tc-99m-diethylenetriamine pentaacetic acid in childhood and adolescence: is it age-dependent?

UNLABELLED: The aim of this study is to assess the accuracy of the pre-existing single-plasma-sample method (SPSM) to measure the glomerular filtration rate (GFR) with Tc-99m-diethylenetriamine pentaacetic acid (Tc-99m-DTPA) in children and adolescents. In addition, the age-independent SPSM is evaluated with two algorithms (Bubeck and Russell) applied for Tc-99m-mercaptoacetyltriglycine (Tc-99m-MAG3) SPSM. PATIENTS AND METHODS: The study was performed on 14 patients (12 men and 2 women; age range 3 to 19 yr) with renal diseases. Tc-99m-DTPA (5 MBq/kg) was injected intravenously and thereafter blood samples were taken at 5, 15, 60, 90, 120, 150 and 180 min via the indwelling tube. Radioactivity in the injection syringe and plasma was measured by means of a double-well single-plastic scintillation counter. The "true" GFR as a reference was determined by two methods: 1) 2-exponential curve fitting 7 samples (GFR7) and 2) 1-exponential curve fitting 3 samples between 90 and 150 min (GFR3) in a slow clearance phase. The GFR7 and GFR3 were searched for to the clearance (GFR1) estimated from a plasma concentration at various sample times by means of 3 equations designed for children (Groth & Aasted, Ham-I and -II) and 3 for adults (Christensen & Groth, Jacobsson, Itoh). RESULTS: All the SPSM showed close correlations (r > 0.95) with the reference methods. Among them, Jacobsson's equation at sample time = 120 min tended to be the most accurate (r = 0.9826, RMSE = 7.8 ml/min)). On the other hand, Ham-I's equation at sample time = 120 min was the most accurate, when it was referred to GFR3 in correction for overestimation (r = 0.9951, RMSE = 4.60 ml/min). The Bubeck and Russells' algorithms showed that the regression equation between the GFR7 and the estimates was different in 2 groups of adults (49 cases) and children/adolescents. CONCLUSION: Our study indicates that Jacobsson's and Christensen & Groth's equations designed for adults are also applicable in determining the GFR with Tc-99m-DTPA in children and adolescents. The algorithms applied for age-independent SPSM with Tc-99m-MAG3 appears to be applicable to SPSM with Tc-99m-DTPA in children, adolescents and adults, but the single age-independent equation with Tc-99m-DTPA will need further investigations.

Adolescent↗
PubMed2002

Urinary megalin deficiency implicates abnormal tubular endocytic function in Fanconi syndrome.

Normal reabsorption of glomerular filtrate proteins probably requires recycling of the endocytic receptors megalin (gp330) and cubilin. Both receptors are located on the luminal surface of the renal proximal tubule epithelium. Whether abnormal amounts of receptor are present in the urine of patients with Dent's disease, Lowe's syndrome, or autosomal dominant idiopathic Fanconi syndrome was explored. They are all forms of the renal Fanconi syndrome and are associated with tubular proteinuria. Urine samples of equal creatinine contents were dialyzed, lyophilized, and subjected to electrophoresis on nonreducing sodium dodecyl sulfate-5% polyacrylamide gels. Proteins were blotted and probed with anti-megalin IgG, anti-cubilin IgG, or receptor-associated protein. Megalin and cubilin levels detected by immunochemiluminescence were measured as integrated pixels and expressed as percentages of the normal mean values. A striking deficiency of urinary megalin, compared with normal individuals (n = 42), was observed for eight of nine families with Dent's disease (n = 10) and for the two families with Lowe's syndrome (n = 3). The family with autosomal dominant idiopathic Fanconi syndrome (n = 2) exhibited megalin levels within the normal range. The measured levels of cubilin were normal for all patients. These results are consistent with defective recycling of megalin to the apical cell surface of the proximal tubules and thus decreased loss into urine in Dent's disease and Lowe's syndrome. This defect would interfere with the normal endocytic function of megalin, result in losses of potential ligands into the urine, and produce tubular proteinuria.

Endocytosis↗
PubMed2002

Clinical analysis of 16 patients with brachial plexus injury.

Brachial plexus injury is very rare in neurosurgical practice, so many neurosurgeons have never experienced this problem in Japan. This study describes a clinical analysis of 16 patients aged 5 to 62 years (mean 32.9 years) who presented at our institution with brachial plexus injuries. Nine patients presented with paralysis and seven with paresis. Head injury was the most common associated injury in eight of 16 patients. Six patients were managed conservatively. All patients with C8-T1 paresis spontaneously recovered to a useful level. Surgery was performed in 10 patients: six neurolysis, two neurotization, and three nerve grafting procedures. All six patients who underwent neurolysis of the brachial plexus attained useful recovery. Four of five patients achieved useful recovery after nerve repair. Nerve grafting achieved a better outcome than neurotization in this study. The difference of outcome was attributed to the graft length. The management of brachial plexus injury is a great challenge, but surgical outcome can be improved if the optimal repair procedure is selected for brachial plexus injury.

Adolescent↗
PubMed2002

Ruptured dissecting anterior inferior cerebellar artery aneurysm--case report.

A 39-year-old woman presented with a rare dissecting aneurysm of the proximal anterior inferior cerebellar artery (AICA). She presented with sudden onset of headache and vomiting, and subsequently became comatose with acute respiratory distress syndrome. Computed tomography showed subarachnoid hemorrhage and ventricular dilation. Left vertebral angiography identified a fusiform aneurysm at the proximal portion of the left AICA. The patient underwent endovascular treatment using Guglielmi detachable coils. The aneurysm was completely embolized. Computed tomography detected no infarcted areas in the regions supplied by the AICA. She was discharged without neurological deficits.

Adult↗
PubMed2002

Upper plexus thoracic outlet syndrome--case report.

A 47-year-old right-handed female became aware of proximal ache and muscle weakness in the right shoulder and elbow in 1997. Atrophy of the right biceps muscle was recognized and the right deltoid, triceps, supraspinatus, and infraspinatus muscles were weak. The Morley test and elevated arm stress test were positive. Neurolysis of the brachial plexus and anterior scalenectomy were performed via a right supraclavicular approach. An abnormal fibromuscular band was identified passing between the upper and middle trunks and constricting the middle trunk. Another scalene muscle anomaly was found passing between the C-5 and C-6 nerve roots and connecting the anterior and middle scalene muscles. These muscles were resected, and thorough neurolysis was performed around all nerves and the trunks. Postoperatively, all symptoms completely resolved and the patient was discharged 5 days after surgery. Thoracic outlet syndrome (TOS) manifests as symptoms of lower cervical nerve involvements with hypesthesia and paresthesia. However, upper plexus TOS manifests as symptoms due to the involvement of the C-5 to C-7 nerve roots, and is relatively rare. Transaxillary first rib resection is performed as the primary operation for TOS, but supraclavicular scalenectomy is effective for upper plexus TOS.

Brachial Plexus↗
PubMedDate not supplied

Cholesterol ester transfer protein in children on peritoneal dialysis.

OBJECTIVES: To examine whether cholesterol ester transfer protein (CETP) activity and mass contribute to dyslipidemia in children on peritoneal dialysis (PD), and to determine whether CETP activity or mass is responsible for severer hyperlipidemia in smaller (younger) patients. STUDY DESIGN: 27 patients (18 males, 9 females; mean age 11.8 +/- 6.1 years) were enrolled. Each patient had been receiving PD for more than 6 months. Fasting blood samples were drawn and CETP activity, CETP mass, total cholesterol, triglyceride, beta-lipoprotein profiles, lipoprotein lipid profiles (cholesterol and triglyceride in lipoproteins), apoprotein profile, and serum albumin levels were measured. The results were then compared, using Student's t-test, with those for a control group. In the patient group, the relationships between CETP activity and each factor were examined using simple and multiple regression analyses. RESULTS: Total cholesterol, triglyceride, low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), chylomicron, and ApoB levels were significantly higher in the patient group. Mean CETP activity levels were 106% +/- 24% in the patient group and 111% +/- 21% in the control group. No significant difference in CETP activity was seen between the two groups, but CETP mass was lower in the patient group than in the control group (2.2 +/- 0.6 microL/dL for the patient group vs 2.8 +/- 0.9 microL/dL for the control group, p = 0.01). As a result, specific CETP activity (activity/protein mass ratio) was significantly higher in the patient group (p < 0.0001). CETP activity was positively related to LDL and other atherogenic factors and negatively related to serum albumin level. No relationship between CETP activity and patient body weight was seen. CONCLUSION: Specific CETP activity was higher in the patient group compared with that in the control group, and strong correlations were found between CETP activity and atherogenic factors in the patient group. Therefore, CETP seems to be associated with lipid abnormalities in children on PD but is not responsible for the severer hyperlipidemia seen in smaller children.

Adolescent↗