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Biomedical subjects

Yasuo Kuroda

Publications and source records attributed to Yasuo Kuroda.

At least 19 recordsLinked to original sources
PubMed2006

A hyperdense artery sign and middle cerebral artery dissection.

We describe a rare case of spontaneous middle cerebral artery (MCA) dissection that caused cerebral infarction and subarachnoid hemorrhage (SAH), which also presented with a hyperdense artery sign. A hyperdense artery sign of the MCA in acute cerebral infarction strongly indicates thromboembolic MCA occlusion, which is often treated with thrombolytic therapy. However, thrombolytic therapy for intracranial artery dissections has both risks and benefits, due to the association of artery dissections with SAH. Therefore, it is important to keep in mind that an MCA dissection can also cause cerebral infarction with a hyperdense artery sign, particularly in young patients presenting with headache.

Adult↗
PubMed2006

Four mutations of the spastin gene in Japanese families with spastic paraplegia.

Hereditary spastic paraplegia (HSP) is a group of genetically heterogeneous neurodegenerative disorders characterized by slowly progressive spasticity and weakness of the lower limbs. HSP is caused by failure of development or selective degeneration of the corticospinal tracts, which contain the longest axons in humans. The most common form of HSP is caused by mutations of the spastin gene (SPAST), located on chromosome 2p21-p22, which encodes spastin, one of the ATPases associated with diverse cellular activities (AAA). In this study, we detected four causative mutations of SPAST among 14 unrelated patients with spastic paraplegia. Two missense mutations (1447A-->G, 1207C-->G) and two deletion mutations (1465delT, 1475-1476delAA) were located in the AAA cassette region. Three of these four mutations were novel. Previous reports and our results suggest that the frequency of SPAST mutations is higher among Japanese patients with autosomal dominant HSP, although SPAST mutations are also observed in patients with sporadic spastic paraplegia.

Adenosine Triphosphatases↗
PubMed2006

[Case of Graves' disease presenting only with rapid consciousness disturbance].

A 79-year-old woman was admitted to our hospital because of forgetfulness for a month followed with rapid development of consciousness disturbance. After admission, the depressed consciousness level fluctuated but continued for more than a month. Thyroid function tests showed increased free T3 and T4 level, lowered level of TSH, and increased anti-TSH receptor antibody titer. A diagnosis of Graves' disease was made but we could find none of thyrotoxic manifestations such as goiter, exophthalmos, tachycardia, high body temperature, or sweating. Administration of thiamazole rapidly improved her consciousness level. It should be kept in mind that hyperthyroidism in elderly could present solely with psychoneurologic symptoms or consiousness disturbance.

Aged↗
PubMed2006

[Regression of a large lipid-rich pool in the coronary artery during treatment with statin detected by intravascular ultrasound: a case report].

A 54-year-old man with unstable angina presented with severe stenosis of the middle segment of the left anterior descending coronary artery. Percutaneous coronary stent implantation and serial intravascular ultrasound (IVUS) were performed. IVUS detected a non-culprit coronary plaque with a large lipid-rich pool in the proximal segment of the left anterior descending coronary artery. Atorvastatin 10 mg/day was given to reduce his cholesterol level for 2 years after the stent implantation. This patient had no cardiac events, and the low-density lipoprotein-cholesterol level reduced from 171 to 88 mg/dl at follow-up. Two-year follow-up IVUS examination revealed the reduction of plaque burden associated with regression of the lipid-rich pool size. This case may indicate that statin could contribute to the regression of lipid-rich plaque and to the stability of coronary plaque.

Angina, Unstable↗
PubMed2005

[An autopsied case of limbic encephalitis associated with extremely high titers of anti-SS-A antibodies in serum and anti-neuronal antibodies in CSF].

A 76-year old man was referred to our department because of several episodes of generalized convulsion followed by a loss of consciousness and the right hemiparesis. The disturbed consciousness and hemiparesis disappeared soon but the personal change persisted thereafter. T2 and diffusion weighted images of MRI taken on the admission showed high intensity lesions in the left medial temporal lobe including the hippocampus. Antibodies (Abs) against herpes simplex virus were not elevated, however, serum titers of antinuclear and anti-SS-A/Ro Abs were extremely elevated. CSF IgG level and IgQ index were increased, and the CSF reacted with 78-kd bands on Western blots of rat brain homogenate. He died of bacterial pneumonia on the 28th day of illness and was autopsied. Malignant tumors were not found in any organs. In the left hippocampus, degeneration and loss of neurons, infiltration of macrophages, and microgliosis were observed. Vasculitis, however, was not found in the lesion. The immunohistochemical study showed that the CSF recognized the cytoplasm of neurons in the human hippocampus and also Purkinje cells. Those immunological and pathological findings thus suggest an antibody-mediated autoimmune limbic encephalitis in our case.

Aged↗
PubMed2004

Central nervous system immunity associated with clinical outcome in acute encephalitis.

To search for useful laboratory measures of central nervous system (CNS) immunity that may provide an accurate prognosis or clues regarding treatment choice, cerebrospinal fluid (CSF) samples were obtained from 14 consecutive patients with acute encephalitis during acute as well as convalescent or chronic stages, and then examined for surface antigen expressions by lymphocytes and the presence of antineuronal tissue antibodies as well as the levels of IgG-related parameters and proinflammatory cytokines, including IL-2, IL-6, IFN-gamma, and tumor necrosis factor-alpha (TNF-alpha). Seven patients with aseptic viral meningitis served as nonencephalitic controls. Eight of the 14 acute encephalitis patients recovered fully, and reductions in the percentages of CD4(+)CD29(+) helper inducer T cells and IL-2 receptor-positive CD4(+) cells were associated with early recovery and favorable outcome, respectively, whereas a low percentage of CD4(+)CD26(+) memory T cells during an acute stage was associated with an unfavorable outcome following adjunctive intravenous corticosteroid treatment. Further, three of the four encephalitis patients who exhibited autoantibodies had a poor prognosis. These findings suggest that CNS immunity status has an effect on prognosis, while flow cytometric analyses of CSF CD4(+) helper T cell subsets may serve as effective means of assessment.

Adolescent↗
PubMed2004

Gyral abnormalities in the early stage of superior sagittal sinus thrombosis.

We report computed tomography (CT) features in a case of segmental thrombosis of the superior sagittal sinus. On the initial cranial CT scan, both frontal cortices showed focal areas of slightly increased attenuation. The lesions were isointense on magnetic resonance (MR) images no matter what pulse sequence was used, except on fluid-attenuated inversion recovery images, which showed curvilinear sulcal hyperintensity. On postcontrast T1-weighted images, curvilinearly enhancing structures were apparent in both frontal cortical sulci. No lesion appeared on follow-up CT or in MR images. We speculated that the areas of slightly increased attenuation in the cortices represented blood congestion in the cortical veins, venules and capillaries without serum leakage. Cranial CT images should be carefully interpreted to avoid overlooking subtle lesions.

Aged↗
PubMed2004

Autoantibodies against heterogeneous nuclear ribonucleoprotein B1 in CSF of MS patients.

Heterogeneous nuclear ribonucleoproteins (hnRNPs) play an important role as the autoantigens in certain autoimmune disorders including neurological diseases such as HTLV-1-associated myelopathy/tropical spastic paraparesis and paraneoplastic neurological syndromes. To clarify their implication in multiple sclerosis (MS), we assayed antibodies (Abs) against hnRNP A and B proteins in sera and cerebrospinal fluid (CSF) of MS patients and compared the results with 25 patients with other neurological diseases (ONDs). Using recombinant hnRNP A1, A2, and B1 proteins and Western blotting for the assay, we found Abs against hnRNP B1 in CSF from 32 of 35 MS patients (91.4%) but not in any sera or CSF of the 25 OND patients. Most notably, no Abs against hnRNP B1 were found in sera of all 22 MS patients examined. Although Abs against hnRNP A1 and A2 were concomitantly found in CSF reacting with B1, their incidence and immunoreactivity were lower or weaker than those of anti-hnRNP B1 Abs. There was no correlation between the reactivity of CSF with hnRNP B1 and CSF parameters-such as the number of the cells and the IgG level-or clinical parameters-such as duration of illness and disease activity. The selective generation of Abs against hnRNP B1 in CSF was shown to be highly specific for MS, which makes them a disease marker.

Adult↗
PubMed2004

Cloning and functional characterization of a rat Daxx that functions as a corepressor for the androgen receptor.

The androgen receptor (AR), a ligand-activated nuclear transcription factor, plays an important role in endocrine system development and homeostasis. AR-mediated gene transcription is modulated by a wide variety of coregulator proteins, but corepressors of AR have not been well characterized. We have isolated a rat homologue of Daxx, a possible AR repressor. The clone obtained comprised a 2196 bp open reading frame, corresponding to a sequence of 731 amino acids with 80.5% homology to mouse. Basal transcription of the isolated clone was repressed in transient transcription experiments using a Gal4 reporter gene assay. Furthermore, a mammalian two-hybrid assay showed a strong interaction between Daxx and promyelocytic leukemia (PML) protein. These results indicate that the isolated clone is a rat homologue of Daxx. The rat Daxx (rDaxx) interacted with the androgen receptor (AR): in co-immunoprecipitation experiments, AR formed complexes with anti-Daxx antibody. Furthermore, overexpression of Daxx suppressed AR-mediated transcriptional activity in HeLa and CV1 cells in transient transfection experiments. Taken together, our results suggest that Daxx may function as a corepressor for the androgen receptor.

Amino Acid Sequence↗
PubMed2004

[A case report of acute polyradiculoneuritis developing after multiple injections of botulinum toxin for cervical dystonia].

A 68-year-old man receiving four times of injection of botulinum toxin type A for cervical dystonia developed acute polyradiculoneuritis 10 weeks after the final injection. He had been complaining of paresthesia in four limbs after the second injection of the treatment. On neurological examination, bilateral facial palsy, bulbar palsy, difficulty of breath, flaccid paralysis of all limbs, sensory disturbance of all modality and areflexia in all limbs, and positive Lasèque sign were noted. Albuminocytological dissociation was present in the CSF and the conduction velocity was significantly impaired in all peripheral nerves examined. After receiving two times of intravenous highdose IgG and two times of pulse therapy, his neurological deficits gradually improved. To our knowledge, this is the third case report of acute polyradiculoneuropathy developing after botulinum toxin therapy, suggesting that botulinum toxin therapy is involved in the pathogenesis in our case.

Acute Disease↗
PubMed2004

[A case of HNPP presenting with late onset of symptoms, chronic progressive course and sensory impairment in face and trunk].

A 69-year-old man was admitted with a chief complaint of progressive muscle weakness and tingling sensation in the distal portion of all extremities since the age of 55. On neurological examination, sensory impairment of all modalities was noted in the right side of face, segmental areas of the right Th4-10 and the distal portion of four extremities. Symmetrical muscle weakness and atrophy was also found over the distal portion of all extremities. All deep tendon reflexes except biceps brachii reflexes were absent. Neurophysiological studies, however, rather indicated mononeuritis multiplex in this case. The biopsied specimen of the sural nerve showed a significant decrease in large myelinated fibers and many tomaculous changes. The gene analysis revealed deletion in the CMT 1A locus on chromosome 17p11.2, providing evidence for the diagnosis of hereditary neuropathy with liability to pressure palsies (HNPP). The development of sensory impairment in face or thoracic nerves is quite rare in HNPP, indicating that there exists considerable phenotypic heterogeneity in the disease.

Aged↗
PubMed2003

EAAT4 mRNA expression is preserved in the cerebellum of prion protein-deficient mice.

To study the mechanism underlying the selective degeneration of Purkinje cells in the cerebellum of the Nagasaki (Ngsk) prion protein-deficient (PrP(-/-)) mice, the mRNA levels of glutamate transporter EAAT4, the marker highly specific for Purkinje cell synapses, were analyzed by semi-quantitative reverse transcription-polymerase chain reaction. EAAT4 mRNA was expressed in the cerebellum of PrP(-/-) mice presenting with cerebellar ataxia, at the levels identical to those in the cerebellum of non-ataxic PrP(+/-) mice. Furthermore, EAAT4 mRNA was identified in the cerebrum of both PrP(-/-) and PrP(+/-) mice, although its levels were much lower than those in the cerebellum. These results indicate that Purkinje cell degeneration found in the cerebellum of PrP(-/-) mice is not primarily caused by glutamate neurotoxicity, although it remains to be investigated whether preserved expression of EAAT4 might represent a compensatory mechanism for protecting against Purkinje cell degeneration in the PrP(-/-) mice cerebellum.

Amino Acid Transport System X-AG↗
PubMed2003

Frontal lobe dysfunction caused by multiple lacunar infarction in community-dwelling elderly subjects.

We examined the factors that influence frontal lobe function among 119 community-dwelling elderly subjects, based on magnetic resonance imaging (MRI) and clinical findings. We interviewed the subjects, and conducted a neurological examination, electrocardiogram, blood test, brain MRI examination, and cognitive function tests. The modified Stroop test and a personal computer version of the Wisconsin Card Sorting Test (WCST) were used to evaluate frontal lobe function. The subjects with impaired frontal lobe function defined by the modified Stroop test were significantly older, had more lacunar infarcts, and had lower HDL cholesterol values based on a logistic regression model. Among the aged who appear apparently normal, multiple lacunar infarcts are the cause of latent frontal lobe dysfunction.

Age Factors↗
PubMed2003

Detection of the 14-3-3 protein in the cerebrospinal fluid of Japanese multiple sclerosis patients presenting with severe myelitis.

Recent studies showed that the 14-3-3 protein is detectable in the cerebrospinal fluid (CSF) of prion-unrelated neurological diseases, such as meningoencephalitis and myelitis. To investigate the possible association between the amounts of the 14-3-3 protein in the CSF and the clinical severity of multiple sclerosis (MS), its levels were determined by Western blot in the CSF of the patients with relapsing-remitting MS (RRMS) (n=10), secondary progressive MS (SPMS) (n=7), primary progressive MS (PPMS) (n=2), and non-MS inflammatory diseases of the CNS (n=5). The 14-3-3 protein was identified in seven CSF samples, including four patients with SPMS in acute relapse, one with SPMS in remission accompanied by fresh cerebral infarction, one with RRMS in acute relapse, and one with human T-lymphotropic virus type I (HTLV-I)-associated myelopathy. The patients positive for the CSF 14-3-3 protein immunoreactivity showed more severe disability and higher levels of pleocytosis, protein, IgG, beta2-microglobulin, and neuron-specific enolase in the CSF, compared with those negative for its immunoreactivity. Four of these patients exhibited extensive lesions distributed along multiple vertebral segments in the spinal cord on MRI. In contrast, none of the MS patients without an extensive involvement of the spinal cord showed the CSF 14-3-3 protein immunoreactivity. These results suggest that detection of the 14-3-3 protein in the CSF provides a marker for severe inflammation-induced extensive damage of the central nervous system tissues responsible for poor therapeutic responses and irreversible neurological deficits in MS.

14-3-3 Proteins↗
PubMed2003

Interferon therapy-responsive brain metabolic abnormalities in a case of adult-onset subacute sclerosing panencephalitis evaluated by 1H MRS analysis.

We describe a 22-year-old woman with an adult-onset, slowly progressive form of subacute sclerosing panencephalitis (SSPE), who was repeatedly evaluated by brain magnetic resonance spectroscopy (MRS). The brain lesion spectrum showed a decrease in N-acetylaspartate (NAA) resonance, an increase in inositol (Ins) resonance, and an unaltered choline signal. These findings suggest neuronal loss and reactive gliosis without inflammation, consistent with brain biopsy findings showing astrocytic proliferation unaccompanied by lymphocytic infiltrates. The unusually protracted clinical course might be attributable to an absence of inflammatory infiltrates in the brain. Intraventricular interferon injection plus oral inosine pranobex treatment produced a substantial improvement in the MRS findings, suggesting the validity of monitoring MRS in SSPE.

Adult↗
PubMed2003

[A case report of Parkinson's disease presenting with recurrent dyspneic attacks due to focal laryngeal dystonia].

A 69-year-old woman suffering from Parkinson's disease for 22 years was admitted because of frequent occurrence of paroxysmal dyspnea for 3 months. Her dyspneic attacks consisting of inspiratory stridor and cyanosis occurred mainly during the wearing-off time and continued for less than 30 min. During nonictal period her respiration and phonation were normal and endoscopic investigation of the vocal cord and upper respiratory tract revealed no abnormality. Based on these findings, she was diagnosed to have focal laryngeal dystonia. The 24-hr monitoring with pulseoxymeter recorded frequent occurrence of paroxysmal asymptomatic hopoxemia during both daytime and sleep. With the treatment of tracheostomy and the reduction and alteration of anti-Parkinsonian drugs, dyspneic attacks disappeared gradually. We also confirmed the complete disappearance of paroxysmal asymptomatic hopoxemia with the 24-hr monitoring by pulseoxymeter, which is considered to be a useful method for early detection of asymptomatic focal laryngeal dystonia.

Aged↗