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Biomedical subjects

Y Sekijima

Publications and source records attributed to Y Sekijima.

At least 19 recordsLinked to original sources

Isolation and characterization of a human alternative complement pathway-inhibiting protein from larval hemolymph of the silkworm, Bombyx mori.

An alternative complement pathway-inhibiting protein (ACPIP), which inhibits the activation of the alternative complement pathway (ACP) of the human serum, was isolated from larval hemolymph of the silkworm, Bombyx mori, by using ammonium sulfate fractionation and column chromatographies to homogeneity. About 400microg of ACPIP was routinely obtained from 20ml hemolymph. The purified ACPIP preparation consisted of two distinct polypeptides (34 and 32kDa) on SDS-PAGE. The amino acid compositions of the two polypeptides were nearly identical; 21% of the amino acid residues were acidic. The amino terminal amino acid sequences up to 20 residues in these two polypeptides were also identical. Addition of the ACPIP to human serum resulted in a dose-dependent inhibition of the hemolysis of intact rabbit erythrocytes via the ACP, whereas in no inhibition of hemolysis of sensitized-sheep erythrocytes (EA) via the classical pathway.

Amino Acid Sequence↗

Early-onset ataxia with ocular motor apraxia and hypoalbuminemia is caused by mutations in a new HIT superfamily gene.

Friedreich ataxia (FRDA), the most common autosomal recessive neurodegenerative disease among Europeans and people of European descent, is characterized by an early onset (usually before the age of 25), progressive ataxia, sensory loss, absence of tendon reflexes and pyramidal weakness of the legs. We have recently identified a unique group of patients whose clinical presentations are characterized by autosomal recessive inheritance, early age of onset, FRDA-like clinical presentations and hypoalbuminemia. Linkage to the FRDA locus, however, was excluded. Given the similarities of the clinical presentations to those of the recently described ataxia with oculomotor apraxia (AOA) linked to chromosome 9p13, we confirmed that the disorder of our patients is also linked to the same locus. We narrowed the candidate region and have identified a new gene encoding a member of the histidine triad (HIT) superfamily as the 'causative' gene. We have called its product aprataxin; the gene symbol is APTX. Although many HIT proteins have been identified, aprataxin is the first to be linked to a distinct phenotype.

Amino Acid Sequence↗

Three patients with isolated adrenocorticotropin deficiency presenting with neuroleptic malignant syndrome-like symptoms.

We report 3 patients with isolated adrenocorticotropin (ACTH) deficiency presenting with neuroleptic malignant syndrome (NMS)-like symptoms. All patients were in their 60's or 70's and showed consciousness disturbance, a high-grade fever, extrapyramydal signs, and muscle enzyme elevations, which met the criteria for NMS. Also, they all showed hyponatremia induced by isolated ACTH deficiency. In addition to the standard therapy for NMS, corticosteroid supplement therapy was effective in all patients. There thus appear to be subjects with isolated ACTH deficiency among patients presenting with NMS-like symptoms, and adrenal and pituitary function should be checked in NMS patients with hyponatremia.

Adrenocorticotropic Hormone↗

Japanese family with an autosomal dominant chromosome instability syndrome: a new neurodegenerative disease?

We report on a Japanese family having an autosomal dominant neurodegenerative disease with chromosomal instability and radiosensitivity. Clinical manifestations of affected members included short stature, osteoporosis, severe dental caries, and various neurological abnormalities, such as mental retardation, depression, dysarthria, hyperreflexia, and ataxic gait. MRI demonstrated a markedly atrophic spinal cord and degeneration of the white matter. Cytogenetic examination showed spontaneous chromosome rearrangements at 14q11.2 and hypersensitivity to radiation and bleomycin. The degree of these cytogenetic abnormalities was significantly higher in the patients than in normal controls but lower than in patients with ataxia telangiectasia or Nijmegen breakage syndrome. Moreover, genetic anticipation was observed in this family: the age of disease onset became earlier, MRI abnormalities more extensive, and the chromosome hypersensitivity to radiation increased in successive generations. We speculate that a basic defect in this family is a mutation in the gene that is responsible for DNA double-strand breakage repair.

Adult↗

Presenilin-1 exists in the axoplasm fraction in the brains of aged Down's syndrome subjects and non-demented individuals.

Missense mutations in the presenilin-1 (PS-1) gene are known to be responsible for early-onset familial Alzheimer's disease (AD). The normal physiological functions of PS-1 are still incompletely understood, although data on the intracellular localization of PS-1 are accumulating, indicating that it exists mainly in endoplasmic reticulum and Golgi compartments. To investigate the localization and functions of PS-1 in the human brain, we separated axoplasm fractions from the cerebral white matter of Down's syndrome (DS) subjects with AD pathology and non-demented individuals using the axonal flotation method, and analyzed them immunocytochemically. All axoplasm fractions contained the 28-34 kDa amino-terminal fragment and the 18 kDa carboxy-terminal fragment of PS-1, although there was no specific abnormality of this protein in the DS brains with AD pathology. This finding indicates that there is intracellular trafficking of PS-1 through the axons in the human brain, and thus provides new information about the physiology of PS-1.

Adult↗

Licorice-induced hypokalemic myopathy and hypokalemic renal tubular damage in anorexia nervosa.

A patient with a history of anorexia nervosa developed licorice-induced hypokalemic myopathy. With potassium replacement, high CPK blood level and myopathic signs returned to normal. However, the patient manifested persistent hypokalemia and impaired renal function to concentrate and acidify the urine. Renal biopsy demonstrated intense degeneration and vacuolation of tubules with a normal glomerus which was consistent with hypokalemic nephropathy. Prolonged hypokalemia in anorexia nervosa is sometimes attributed to surreptitious purging or taking diuretics, but it is necessary to check the urine pH, the urine-specific gravity, and the urine potassium level in order to find underlying renal damage even after hypokalemic myopathy is treated successfully.

Adult↗

[Sarin poisoning].

Explore the source record for details and available documents.

Autonomic Nervous System Diseases↗

Hereditary motor and sensory neuropathy associated with cerebellar atrophy (HMSNCA): clinical and neuropathological features of a Japanese family.

We report clinicopathological features of a Japanese family with hereditary motor and sensory neuropathy associated with cerebellar atrophy (HMSNCA). Four affected members from a single generation were examined. They shared common clinical features, including insidious onset in teenage, slowly progressive cerebellar ataxia, amyotrophy, sensory disturbance, and dementia. In addition, all the patients showed hypoalbuminemia and hyperlipidemia and a marked atrophy of the cerebellum on magnetic resonance images. Autopsy of the proband revealed a severe loss of Purkinje cells, degeneration of posterior columns and spinocerebellar tracts of the spinal cord, and a marked loss of myelinated and unmyelinated fibers in the peripheral nerves. We consider that HMSNCA is a distinct form of hereditary multisystem neuronal degeneration.

Age of Onset↗

Prevalence of dementia of Alzheimer type and apolipoprotein E phenotypes in aged patients with Down's syndrome.

We investigated the exact prevalence of dementia of Alzheimer type (DAT) and apolipoprotein E (ApoE) phenotypes in 106 Japanese Down's syndrome (DS) patients. Among these patients 16 were diagnosed as having DAT. The prevalence of DAT was 0% in the 30- to 39-year-old group, 16% in the 40- to 49-year-old group, and 38% in those over 50 years old. The frequency of the epsilon4 allele in DS patients with DAT was 18.8%, which was considerably higher than that of nondemented DS patients (4.5%) and Japanese nondemented controls (6.7%). Especially, the frequency of the epsilon4 allele in DS patients who developed DAT under 50 years was significantly higher (28.6%). DS patients certainly develop DAT at earlier ages but the prevalence of DAT in each group of patients was lower than previously recognized. It is very likely that the ApoE epsilon4 is a risk factor for DAT even in DS patients with a genetic predisposition to Alzheimer's disease.

Adult↗

A case of mitochondrial cytopathy with a typical point mutation for MELAS, presenting with severe focal-segmental glomerulosclerosis as main clinical manifestation.

A 27-year-old female with short stature and mild hearing loss was diagnosed as having focal-segmental glomerulosclerosis by renal biopsy at our hospital. One year later she developed progressive renal dysfunction and cardiac failure and was admitted again to our hospital for evaluation. Though her only neurological disorder was mild hearing loss, her short stature and elevated lactate and pyruvate values in cerebrospinal fluid suggested mitochondrial cytopathy. A muscle biopsy specimen of the left biceps brachii, using modified Gomori trichrome stain, showed a typical image of ragged-red fibers, and an increased number of giant mitochondria with paracrystalline inclusions were visible by electron microscopy. Mitochondrial DNA from the skeletal muscle showed an A-to-G transition at 3243 of transfer RNALeu(UUR), the common point mutation for mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes. These data confirmed the diagnosis of atypical mitochondrial cytopathy with renal and heart involvement. Mitochondrial cytopathies are often associated with hypertrophic cardiomyopathy but rarely with renal disease. Among the few reported cases with associated renal disease, most included renal tubular disorders; few cases with focal glomerular sclerosis are known. The present case of atypical mitochondrial cytopathy was characterized by a unique clinical course and rare complications with focal-segmental glomerulosclerosis.

Adult↗

[A case of chronic inflammatory demyelinating polyradiculoneuropathy complicated by phrenic nerve palsy].

We report on a patient with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) complicated by phrenic nerve palsy. A 50-year-old man was admitted to our hospital due to dyspnea and numbness in his limbs. On admission, severe muscle atrophy, weakness, and sensory disturbance were seen in the distal part of his extremities. Deep tendon reflexes were absent in all the limbs. Routine blood examinations showed no abnormal findings except for mild hyperglycemia (fasting blood sugar 145 mg/dl). Right phrenic nerve palsy was observed on a chest roentgenogram and % vital capacity (%VC) was 56%. Cerebrospinal fluid showed elevated levels of total protein (116 mg/dl) and IgG (16.9 mg/dl). Sural nerve biopsy revealed severe loss of myelinated fibers with demyelination and onion-bulb formation. After immunoadsorption plasmapheresis, the phrenic nerve palsy improved rapidly and %VC recovered to 76%. Although phrenic nerve palsy is rare in patients with CIDP, it is important to take notice of this condition, because phrenic nerve palsy is critical when it occurs bilaterally or when it develops in patients who have suffered from respiratory diseases. Immunoadsorption plasmapheresis is one of the effective treatments for CIDP, especially in patients with serious complications such as phrenic nerve palsy.

Chronic Disease↗

[A case of severe status epilepticus of frontal lobe origin successfully treated with corticosteroids].

A 17-year-old girl was admitted to our hospital due to low-grade fever, confusion, numbness in her right hand and automatism. On admission, she was slightly disoriented but there were no meningeal signs. Weakness and sensory disturbance were observed in her right hand. Automatism and clonic seizures frequently appeared. Electroencephalography revealed frequent delta bursts in her left frontal lobe. 123I-IMP-SPECT study showed abnormally increased isotope uptake in the left cerebral hemisphere. She was diagnosed as status epilepticus of left frontal lobe origin and treated with anti-convulsants including carbamazepine, phenytoin, diazepam, phenobarbital, and thiopental, which were not effective. Then we started corticosteroid therapy. Three cycles of intravenous injections of methylprednisolone, followed by oral prednisolone led to marked improvement in her symptoms. It is known that corticosteroid decreases the threshold of seizure, so we do not use it for idiopathic epilepsy. On the other hand, in some secondary epilepsy due to vasculitis in the brain, corticosteroid is very effective for seizures. It is still unclear whether our patient actually had vasculitis or not. However, it is important to recognize that steroid therapy might be effective in a certain portion of epilepsies resistant to anti-convulsants, especially in young patients with non-infectious fever.

Administration, Oral↗

Plasma levels of amyloid beta proteins Abeta1-40 and Abeta1-42(43) are elevated in Down's syndrome.

To investigate the effect of the overexpression of beta-amyloid precursor protein (APP) on the production of two major amyloid beta protein (Abeta) species, Abeta40 and Abeta42(43), we measured amounts of Abeta1-40 and Abeta1-42(43) in the plasma from 44 patients with Down's syndrome (DS) (age, 19-61 years) and 66 age-matched normal controls using enzyme-linked immunosorbent assays. Plasma concentrations of both Abeta1-40 and Abeta1-42(43) were increased about 3-fold and 2-fold, respectively, in DS patients compared with normal controls. Especially, the increases in plasma Abeta1-40 in DS patients were statistically higher than the 1.5-fold increase one might predict based on the gene dose of APP in DS. These findings showed that both Abeta1-40 and Abeta1-42(43) are increased in plasma in DS patients, the former more than the latter, suggesting that overexpression of APP and/or other genes may have different effects on the production of these two Abeta species in DS.

Adult↗

Serial magnetic resonance imaging (MRI) study of a patient with Balo's concentric sclerosis treated with immunoadsorption plasmapheresis.

A 28-year-old Japanese woman with Balo's concentric sclerosis developed a rapidly progressive form of encephalopathy. Magnetic resonance imaging (MRI) showed multiple concentric lesions in the central white matter and the cerebellum. The administration of corticosteroid regimen resulted in little benefit. Immunoadsorption plasmapheresis led to a remission within 1 month of onset. Serial MRI study was described here for the first time, which allowed us to observe the development of concentric structures. The observation indicated that, initially, a central core, a round demyelinated area, and surrounding edema appeared around a vessel. Subsequently, concentric demyelinated bands formed simultaneously, not centrifugally, with diminution of the edema. Analysis of cerebrospinal fluid showed elevated levels of interleukin-6 and tumor necrosis factor-alpha. The success of immunoadsorption plasmapheresis therapy in this patient suggests that both humoral demyelinating factors and cell-mediated immunity may be involved in the pathogenesis of this disorder.

Adult↗

No association between apolipoprotein E epsilon4 allele and the age of onset in type I familial amyloid polyneuropathy.

It has been shown that the Apolipoprotein E (ApoE) epsilon4 allele increases the risk of developing Alzheimer's disease (AD) and lowers the age of its onset. ApoE has also been suggested to be a common facilitating factor in the different types of amyloidoses. However, the association of ApoE epsilon4 with the onset of disease in various types of amyloidoses has not been extensively investigated. Type I familial amyloid polyneuropathy (FAP) is one form of systemic amyloidosis in which ApoE co-localizes with amyloid deposits. We examined 54 patients with type I FAP and found that there was no significant effect of either ApoE epsilon2 or epsilon4 allele on the age at onset. Our results suggest that ApoE4 is not a facilitating factor in the development of FAP, transthyretin amyloidosis.

Age of Onset↗

Cytoplasmic body myopathy with hypertrophic cardiomyopathy.

A patient with cytoplasmic body myopathy presented muscle hypotonia from birth and developed progressive muscular atrophy and weakness, scoliosis, contracture of joints and cardiorespiratory failure. At the age of 17, he died of heart failure. Post mortem examination revealed severe hypertrophy of cardiac walls and generalized muscular atrophy. Microscopic examination showed many cytoplasmic bodies in skeletal muscle fibers and myofiber disarray in myocardium. No cases of cytoplasmic body myopathy with hypertrophic cardiomyopathy have been reported previously. It is suggested that the Z-line component is related to the formation of the cytoplasmic body in skeletal muscle and disarray in the cardiac muscle.

Adolescent↗