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Nimura T, Aomura D, Harada M, Yamaguchi A, Yamaka K, Nakajima T, Tanaka N, Ehara T, Hashimoto K, Kamijo Y. Investigation of Clinical Features and Association between Vascular Endothelial Injury Markers and Cytomegalovirus Infection Associated with Thrombotic Microangiopathy in Patients with Anti-Neutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis: Case-Based Research. Int J Mol Sci 2024; 25:812. [PMID: 38255886 PMCID: PMC10815804 DOI: 10.3390/ijms25020812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/01/2024] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) can occasionally trigger thrombotic microangiopathy (TMA). Cytomegalovirus (CMV) may be reactivated during intensive immunosuppressive therapy for AAV and cause TMA. Therefore, we aimed to evaluate the clinical features of and the association between vascular endothelial injury markers and TMA due to CMV in patients with AAV. A 61-year-old female was diagnosed with AAV and severe kidney injury. Immunosuppressive therapy gradually improved her symptoms and laboratory findings. However, 2 weeks after induction therapy initiation, she exhibited altered consciousness, a significant decrease in platelet count, and hemolytic anemia, resulting in a TMA diagnosis. Plasma exchange did not improve TMA findings and routine screening test revealed CMV infection. Ganciclovir injection improved the infection and TMA findings. Consequently, we diagnosed her with CMV-induced TMA. Both AAV and CMV may induce severe vascular endothelial injury, potentially leading to TMA development. CMV-induced TMA should be considered when TMA develops during induction therapy against AAV. Moreover, of the three serum markers of vascular injury-serum sulfatides, soluble thrombomodulin, and pentraxin 3-serum sulfatides may be associated with the development of TMA, and a high level of soluble thrombomodulin may be associated with the development of CMV viremia during the clinical course of AAV.
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Affiliation(s)
- Takayuki Nimura
- Department of Nephrology, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto 390-8621, Japan; (T.N.); (D.A.); (A.Y.); (K.Y.); (K.H.)
| | - Daiki Aomura
- Department of Nephrology, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto 390-8621, Japan; (T.N.); (D.A.); (A.Y.); (K.Y.); (K.H.)
| | - Makoto Harada
- Department of Nephrology, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto 390-8621, Japan; (T.N.); (D.A.); (A.Y.); (K.Y.); (K.H.)
| | - Akinori Yamaguchi
- Department of Nephrology, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto 390-8621, Japan; (T.N.); (D.A.); (A.Y.); (K.Y.); (K.H.)
| | - Kosuke Yamaka
- Department of Nephrology, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto 390-8621, Japan; (T.N.); (D.A.); (A.Y.); (K.Y.); (K.H.)
| | - Takero Nakajima
- Department of Metabolic Regulation, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto 390-8621, Japan;
- Center for Medical Education and Training, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto 390-8621, Japan
| | - Naoki Tanaka
- Department of Global Medical Research Promotion, Shinshu University Graduate School of Medicine, 3-1-1, Asahi, Matsumoto 390-8621, Japan;
- International Relations Office, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto 390-8621, Japan
- Research Center for Social Systems, Shinshu University, 3-1-1, Asahi, Matsumoto 390-8621, Japan
| | - Takashi Ehara
- Department of Pathology, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto 390-8621, Japan;
| | - Koji Hashimoto
- Department of Nephrology, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto 390-8621, Japan; (T.N.); (D.A.); (A.Y.); (K.Y.); (K.H.)
| | - Yuji Kamijo
- Department of Nephrology, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto 390-8621, Japan; (T.N.); (D.A.); (A.Y.); (K.Y.); (K.H.)
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Aomura D, Harada M, Nakajima T, Nimura T, Yamaka K, Yamada Y, Hashimoto K, Tanaka N, Kamijo Y. Serum sulfatide level is associated with severe systemic vasculitis with kidney involvement. Front Immunol 2023; 14:1271741. [PMID: 38111574 PMCID: PMC10726124 DOI: 10.3389/fimmu.2023.1271741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/17/2023] [Indexed: 12/20/2023] Open
Abstract
Sulfatides are a type of sulfated glycosphingolipid that are secreted with lipoproteins into the serum. These molecules are involved in the inflammatory pathway of vessels in addition to coagulation and platelet aggregation. Previous studies have proposed that sulfatides play a pivotal role in regulating inflammation-related disorders. Systemic vasculitis (SV) diseases are generally caused by autoimmune diseases and often involve kidney vasculitis, which may lead to rapidly progressive kidney dysfunction and end-stage kidney disease. Our earlier pilot study revealed that the level of serum sulfatides (SSs) was significantly decreased in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), a representative disease-causing SV with kidney involvement (SVKI), especially in patients exhibiting active crescentic findings on kidney biopsy. To further explore the clinical significance of an association between SS and SVKI, we analyzed and compared the SS level of patients with various SVKI diseases in this retrospective cohort study. Among patients admitted to our hospital between 2008 and 2021, we ultimately enrolled 26 patients with IgA vasculitis (IgAV), 62 patients with AAV, and 10 patients with anti-glomerular basement membrane disease (GBM) as examples of SVKI diseases, as well as 50 patients with IgA nephropathy (IgAN) and 23 donors for living kidney transplantation as controls. The mean ± standard deviation SS level in the donor, IgAN, IgAV, AAV, and GBM groups was 8.26 ± 1.72, 8.01 ± 2.21, 6.01 ± 1.73, 5.37 ± 1.97, and 2.73 ± 0.99 nmol/mL, respectively. Analysis of patients in the SVKI disease group showed that those with the crescentic class kidney biopsy finding exhibited a significantly lower SS level than did those with other class biopsy features. Additionally, the SS level had a higher detection ability for SVKI patients with crescentic class kidney biopsy findings (area under the receiver operating characteristic curve 0.90, 95% confidence interval 0.82-0.99) than did several other predictor candidates. Our results indicate that the SS level is decreased in more severe SVKI diseases and may be associated with active glomerular lesions in SVKI kidney biopsy samples.
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Affiliation(s)
- Daiki Aomura
- Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Makoto Harada
- Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takero Nakajima
- Department of Metabolic Regulation, Shinshu University School of Medicine, Matsumoto, Japan
- Center for Medical Education and Training, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takayuki Nimura
- Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kosuke Yamaka
- Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yosuke Yamada
- Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Koji Hashimoto
- Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Naoki Tanaka
- Department of Global Medical Research Promotion, Shinshu University Graduate School of Medicine, Matsumoto, Japan
- International Relations Office, Shinshu University School of Medicine, Matsumoto, Japan
- Research Center for Social Systems, Shinshu University, Matsumoto, Japan
| | - Yuji Kamijo
- Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Japan
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Nimura T, Itoh T, Hagio H, Hayashi T, Di Donato V, Takeuchi M, Itoh T, Inoguchi F, Sato Y, Yamamoto N, Katsuyama Y, Del Bene F, Shimizu T, Hibi M. Role of Reelin in cell positioning in the cerebellum and the cerebellum-like structure in zebrafish. Dev Biol 2019; 455:393-408. [PMID: 31323192 DOI: 10.1016/j.ydbio.2019.07.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 07/05/2019] [Accepted: 07/14/2019] [Indexed: 02/07/2023]
Abstract
The cerebellum and the cerebellum-like structure in the mesencephalic tectum in zebrafish contain multiple cell types, including principal cells (i.e., Purkinje cells and type I neurons) and granule cells, that form neural circuits in which the principal cells receive and integrate inputs from granule cells and other neurons. It is largely unknown how these cells are positioned and how neural circuits form. While Reelin signaling is known to play an important role in cell positioning in the mammalian brain, its role in the formation of other vertebrate brains remains elusive. Here we found that zebrafish with mutations in Reelin or in the Reelin-signaling molecules Vldlr or Dab1a exhibited ectopic Purkinje cells, eurydendroid cells (projection neurons), and Bergmann glial cells in the cerebellum, and ectopic type I neurons in the tectum. The ectopic Purkinje cells and type I neurons received aberrant afferent fibers in these mutants. In wild-type zebrafish, reelin transcripts were detected in the internal granule cell layer, while Reelin protein was localized to the superficial layer of the cerebellum and the tectum. Laser ablation of the granule cell axons perturbed the localization of Reelin, and the mutation of both kif5aa and kif5ba, which encode major kinesin I components in the granule cells, disrupted the elongation of granule cell axons and the Reelin distribution. Our findings suggest that in zebrafish, (1) Reelin is transported from the granule cell soma to the superficial layer by axonal transport; (2) Reelin controls the migration of neurons and glial cells from the ventricular zone; and (3) Purkinje cells and type I neurons attract afferent axons during the formation of the cerebellum and the cerebellum-like structure.
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Affiliation(s)
- Takayuki Nimura
- Division of Biological Science, Graduate School of Science, Nagoya University, Furo, Chikusa, Nagoya, Aichi, 464-8602, Japan
| | - Tsubasa Itoh
- Division of Biological Science, Graduate School of Science, Nagoya University, Furo, Chikusa, Nagoya, Aichi, 464-8602, Japan
| | - Hanako Hagio
- Division of Biological Science, Graduate School of Science, Nagoya University, Furo, Chikusa, Nagoya, Aichi, 464-8602, Japan; Department of Animal Sciences, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Aichi, 464-8601, Japan
| | - Takuto Hayashi
- Division of Biological Science, Graduate School of Science, Nagoya University, Furo, Chikusa, Nagoya, Aichi, 464-8602, Japan
| | - Vincenzo Di Donato
- Institut Curie, PSL Research University, INSERM U934, CNRS UMR3215, UPMC Paris-Sorbonne, Paris, 75005, France
| | - Miki Takeuchi
- Bioscience and Biotechnology Center, Nagoya University, Furo, Chikusa, Nagoya, Aichi, 464-8601, Japan
| | - Takeaki Itoh
- Department of Anatomy, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
| | - Fuduki Inoguchi
- Department of Anatomy, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
| | - Yoshikatsu Sato
- Institute of Transformative Bio-Molecules, Nagoya University, Furo, Chikusa, Nagoya, Aichi, 464-8601, Japan
| | - Naoyuki Yamamoto
- Department of Animal Sciences, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Aichi, 464-8601, Japan
| | - Yu Katsuyama
- Department of Anatomy, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
| | - Filippo Del Bene
- Institut Curie, PSL Research University, INSERM U934, CNRS UMR3215, UPMC Paris-Sorbonne, Paris, 75005, France
| | - Takashi Shimizu
- Division of Biological Science, Graduate School of Science, Nagoya University, Furo, Chikusa, Nagoya, Aichi, 464-8602, Japan; Bioscience and Biotechnology Center, Nagoya University, Furo, Chikusa, Nagoya, Aichi, 464-8601, Japan
| | - Masahiko Hibi
- Division of Biological Science, Graduate School of Science, Nagoya University, Furo, Chikusa, Nagoya, Aichi, 464-8602, Japan; Bioscience and Biotechnology Center, Nagoya University, Furo, Chikusa, Nagoya, Aichi, 464-8601, Japan.
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Senga Y, Nagamine T, Nimura T, Sueyoshi N, Kameshita I. P19. Ca2+/calmodulin-dependent protein kinase I (CaMKI)-δ is indispensable for normal embryogenesis in zebrafish, Danio rerio. Differentiation 2010. [DOI: 10.1016/j.diff.2010.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nimura T, Sugiyama Y, Sueyoshi N, Shigeri Y, Ishida A, Kameshita I. A minimum size homologue of Ca2+/calmodulin-dependent protein kinase IV naturally occurring in zebrafish. J Biochem 2010; 147:857-65. [DOI: 10.1093/jb/mvq021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abe M, Takagi Y, Kitazato K, Abe S, Hiroi T, Vilas F, Clark BE, Abell PA, Lederer SM, Jarvis KS, Nimura T, Ueda Y, Fujiwara A. Near-Infrared Spectral Results of Asteroid Itokawa from the Hayabusa Spacecraft. Science 2006; 312:1334-8. [PMID: 16741108 DOI: 10.1126/science.1125718] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The near-infrared spectrometer on board the Japanese Hayabusa spacecraft found a variation of more than 10% in albedo and absorption band depth in the surface reflectance of asteroid 25143 Itokawa. Spectral shape over the 1-micrometer absorption band indicates that the surface of this body has an olivine-rich mineral assemblage potentially similar to that of LL5 or LL6 chondrites. Diversity in the physical condition of Itokawa's surface appears to be larger than for other S-type asteroids previously explored by spacecraft, such as 433 Eros.
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Affiliation(s)
- M Abe
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, 3-1-1 Yoshinodai, Sagamihara, Kanagawa 229-8510, Japan
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Komatsuda A, Wakui H, Ohtani H, Maki N, Nimura T, Takatsu H, Yamaguchi A, Imai H, Sawada K. Amyloid A-type renal amyloidosis in a patient with sarcoidosis: report of a case and review of the literature. Clin Nephrol 2003; 60:284-8. [PMID: 14579945 DOI: 10.5414/cnp60284] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A 53-year-old man developed chronic renal failure during a protracted course of sarcoidosis. A renal biopsy showed Congo red-positive homogenous deposits in the subendothelial space of glomerular capillary walls and arterial walls. On electron microscopy, amyloid fibrils were observed in the deposits. Immunohistochemistry showed positive staining for amyloid A (AA) protein. Treatment with prednisolone resulted in poor response, followed by progressive deterioration of renal function requiring hemodialysis. To our knowledge, there are 5 cases with histologically proven renal amyloidosis accompanied by sarcoidosis. Prognosis in these patients is extremely poor. AA-type amyloidosis should be considered as a rare renal complication in the setting of long-standing sarcoidosis.
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Affiliation(s)
- A Komatsuda
- Third Department of Internal Medicine, Akita University School of Medicine, Akita City, Akita, Jaan.
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Nimura T. The epidemic of 994 and rumors. (Jpn). Igakushi Kenkyu 2001; 39:445-51. [PMID: 11610615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Komatsuda A, Ohtani H, Nimura T, Yamaguchi A, Wakui H, Imai H, Miura AB. Endocapillary proliferative glomerulonephritis in a patient with parvovirus B19 infection. Am J Kidney Dis 2000; 36:851-4. [PMID: 11007690 DOI: 10.1053/ajkd.2000.17718] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 45-year-old woman developed acute nephritic syndrome after erythema infectiosum. Laboratory data on admission showed decreased serum C3, C4, and CH50 levels and the presence of both immunoglobulin (Ig) M and IgG antibodies to human parvovirus B19 (HPV). A renal biopsy showed diffuse endocapillary proliferative glomerulonephritis. Immunofluorescence microscopy indicated 2+ granular staining for IgG, IgM, and C3 over the mesangial area and along glomerular capillary walls. HPV antigen was also detected in glomeruli by immunohistochemistry. Electron microscopy showed electron-dense deposits in the subendothelial space and the paramesangial area. These findings suggest that immune complex-type glomerulonephritis is caused by glomerular deposition of HPV antigen-antibody complexes in some patients with HPV infection.
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Affiliation(s)
- A Komatsuda
- Third Department of Internal Medicine, Akita University School of Medicine, and the Department of Internal Medicine, Senboku General Hospital, Akita,
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Kitabayashi A, Hirokawa M, Horiuchi T, Kawabata Y, Miura AB, Sakuyama M, Nimura T, Niitsu H. [Pulmonary complications after allogeneic hematopoietic stem cell transplantation]. Rinsho Ketsueki 2000; 41:310-5. [PMID: 10846461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
We investigated the occurrence of pulmonary complications in patients who underwent allogeneic hematopoietic stem cell transplantation at our institution. Pulmonary complications were observed in 12 out of 60 patients. Interstitial pneumonia developed in 12 cases: 7 idiopathic, 2 cytomegalovirus-associated, 1 P. carinii, 1 HSV, and 1 HHV-6-associated. HSV- and HHV-6-associated pneumonias were exhibited 100 days after transplantation. PCR analysis was diagnostically useful for detection of viral DNA in bronchial alveolar lavage fluid. Respiratory disease with airway obstruction was observed in 4 patients with chronic graft-versus-host disease, and all 4 had a history of interstitial pneumonia. Three patients died of respiratory failure. Mycobacicrium avium complex was detected in 2. Exacerbation of respiratory failure may be associated with mycobacterial infection.
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Affiliation(s)
- A Kitabayashi
- Third Department of Internal Medicine, Akita University
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Oyama Y, Komatsuda A, Ohtani H, Imai H, Kitabayashi A, Yamaguchi A, Nimura T, Miura AB, Nakamoto Y. Extensive intraglomerular thrombi of monoclonal IgM-kappa in a patient with malignant lymphoma. Am J Kidney Dis 2000; 35:E11. [PMID: 10692296 DOI: 10.1016/s0272-6386(00)70223-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We describe an 80-year-old man who developed malignant lymphoma (ML) complicated by extensive intraglomerular thrombi of immunoglobulin M (IgM)-kappa monoclonal immunoglobulin. The clinical picture was characterized by nephrotic syndrome and systemic lymphadenopathy. Laboratory examination showed mild anemia and a small amount of monoclonal IgM-kappa in the blood. The histopathologic findings and surface immunoglobulin analysis of the lymph node biopsy specimen were consistent with CD5-positive diffuse large B-cell (type, IgM-kappa) lymphoma. The subsequent renal biopsy showed a massive deposition of amorphous material in the glomerular capillary lumens, subendothelial areas, and mesangium. Nodular glomerulosclerosis was not found. An immunofluorescent study showed that the deposits consisted of IgM-kappa monoclonal immunoglobulin. Ultrastructurally, the deposits were composed of granular electron-dense material. Chemotherapy was effective for both the ML and nephrotic syndrome, and the patient's urine analysis results returned to normal. The histopathologic manifestations of this case are rare, and the pathogenesis of these glomerular lesions was obviously associated with ML.
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Affiliation(s)
- Y Oyama
- Third Department of Internal Medicine, Akita University School of Medicine, Japan
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Nimura T, Oku T, Narita N, Higuchi H. [Dissecting aneurysm of the middle cerebral artery: case report]. No Shinkei Geka 2000; 28:61-5. [PMID: 10642995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
We present a surgical case of a dissecting aneurysm of the right middle cerebral artery associated with subarachnoid hemorrhage and intracranial hemorrhage. A 61-year-old woman with consciousness disturbance and left hemiplegia was referred to our hospital. She had suffered severe headache for a week. CT scan showed a subarachnoid hemorrhage in the right Sylvian fissure and intracranial hemorrhage in the right putamen. The right carotid angiogram revealed string sign in M1 portion and occlusion at M2 lower branch of the right middle cerebral artery. On the 12th day, we undertook surgery to confirm whether it was a dissecting aneurysm or not. In the operation, it was reddish in the M1 portion corresponding to the "string sign" and dark-purplish in the lower M2 portion corresponding to an "aneurysm-like lesion". To prevent bleeding, the arterial wall in the M1 portion was coated using muscle. Though the left hemiplegia was unchanged, the postoperative course was uneventful. The patient was transferred to another hospital and underwent rehabilitation. There has been no reccurrence during the four years since surgery. The middle cerebral artery dissecting aneurysm is extremely rare. We presented this case with review of the literature.
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Affiliation(s)
- T Nimura
- Department of Neurosurgery, Miyako Prefectural Hospital
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Saitoh K, Miura I, Kobayashi Y, Kume M, Utsumi S, Takahashi N, Hatano Y, Nimura T, Hashimoto K, Takahashi S, Miura AB. A new variant translocation of t(15;17) in a patient with acute promyelocytic leukemia (M3): t(15;19;17)(q22;p13;q12). Cancer Genet Cytogenet 1998; 102:15-8. [PMID: 9530334 DOI: 10.1016/s0165-4608(97)00299-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The reciprocal translocation (15;17) is specifically associated with acute promyelocytic leukemia [APL; M3 subtype according to French-American-British (FAB) classification]. A few patients with this disease have complex variant translocations. We describe a patient with M3 carrying t(15;19;17)(q22;p13;q12), which is a new type of variant translocation. The karyotypic interpretation was confirmed by Southern blot analysis with the use of RAR alpha and by fluorescence in situ hybridization (FISH) with the use of painting probes of chromosomes 15, 17, and 19 and a (15;17) translocation DNA probe. The results support the idea that the key event in APL is the formation of fusion gene PML/RAR alpha on the der(15).
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MESH Headings
- Adolescent
- Blotting, Southern
- Chromosomes, Human, Pair 15
- Chromosomes, Human, Pair 17
- Chromosomes, Human, Pair 19
- Female
- Humans
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Promyelocytic, Acute/genetics
- Translocation, Genetic
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Affiliation(s)
- K Saitoh
- Third Department of Internal Medicine, Akita University School of Medicine, Japan
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Ohshima A, Miura I, Hashimoto K, Takahashi N, Utsumi S, Nimura T, Saito M, Miki T, Hirosawa S, Miura AB. Rearrangements of the BCL6 gene and chromosome aberrations affecting 3q27 in 54 patients with non-Hodgkin's lymphoma. Leuk Lymphoma 1997; 27:329-34. [PMID: 9402330 DOI: 10.3109/10428199709059687] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Chromosome aberrations affecting 3q27 are among the most frequent non-random abnormalities in non-Hodgkin's lymphomas (NHL), especially the diffuse, large cell type. Recently, an association between BCL6 rearrangement and frequent extranodal lesions, rare bone marrow infiltration and a favorable clinical outcome was reported. We performed molecular studies of the BCL6 gene in 54 patients with NHL. Twelve patients (22%) with rearranged BCL6 genes were selected for histological, clinical, molecular, and cytogenetic studies. Ten of these cases were diffuse, large cell type lymphoma, one a follicular lymphoma, and one a mantle cell lymphoma (MCL). All cases were of the B-cell type and this is the first time a rearranged BCL6 gene has been found in an MCL. Cytogenetic data for 10 cases were available and the partner sites of the 3q27 translocation were determined in 7 of 10 patients. These locations were variable, including 6p21.3, 9p22, and 14q11 in addition to the immunoglobulin loci 14q32 (IGH), 2p12 (IGK), and 22q11 (IGL). The heterogeneity in partner sites is distinct from other lymphoma subgroups and may suggest that the genetic events are not uniform among patients with BCL6 rearrangements.
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Affiliation(s)
- A Ohshima
- Third Department of Internal Medicine, Akita University School of Medicine, Japan
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Kawabata Y, Hirokawa M, Horiuchi T, Hatakeyama T, Kobayashi Y, Saito K, Kume M, Nimura T, Nishinari T, Miura AB. [Autologous peripheral blood stem cell transplantation for CHOP-resistant mediastinal diffuse large B-cell lymphoma]. Rinsho Ketsueki 1997; 38:674-81. [PMID: 9311274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We report two cases of CHOP-resistant mediastinal diffuse large B-cell lymphoma (MDLCL) treated by autologous peripheral blood stem cell transplantation (auto-PBSCT). The patients were 17 and 28 year old female, and they had anterior mediastinal bulky masses at presentation. The clinical stage was IV in both patients. They were initially treated with 6 courses of bi-weekly CHOP therapy following by irradiation of the mediastinal tumors. During the last few cycles of CHOP therapy, their disease had become progressive. They underwent auto-PBSCT after high-dose chemotherapy consisting of busulfan, cyclophosphamide and etoposide, but failed to achieve remission. They died within one year after the auto-PBSCT because of the disease progression. Our experience suggests that this conditioning regimen is not effective for CHOP-resistant MDLCL, and it is necessary to develop new conditioning regimens.
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Affiliation(s)
- Y Kawabata
- Department of Internal Medicine III, Akita University School of Medicine
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16
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Saitoh K, Miura I, Ohshima A, Takahashi N, Kume M, Utsumi S, Kobayashi Y, Hashimoto K, Hatano Y, Nimura T, Saito M, Enomoto K, Ohhira M, Shimizu K, Ohki M, Miura AB. Translocation (8;12;21)(q22.1;q24.1;q22.1): a new masked type of t(8;21)(q22;q22) in a patient with acute myeloid leukemia. Cancer Genet Cytogenet 1997; 96:111-4. [PMID: 9216716 DOI: 10.1016/s0165-4608(96)00320-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The translocation t(8;21)(q22;q22) is found in 40% of cases of acute myeloid leukemia (AML) designated as the subtype M2 in the French-American-British (FAB) classification. The 8;21 translocation is clinically of interest because patients with this subtype have a good prognosis. We describe a masked type of the translocation, t(8;12;21)(q22.1;q24.1;q22.1). The translocation was first interpreted as t(8;12)(q22;q24) based on cytogenetics, but was reevaluated as a result of Southern blot and fluorescence in situ hybridization (FISH) analyses.
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Affiliation(s)
- K Saitoh
- Third Department of Internal Medicine, Akita University School of Medicine, Japan
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17
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Mancuso A, Nimura T, Weinstein PR. Prediction of delayed ischemic injury with diffusion-weighted MRI following temporary middle cerebral artery occlusion in rats. Brain Res 1997; 760:42-51. [PMID: 9237516 DOI: 10.1016/s0006-8993(97)00274-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Early reductions in the apparent diffusion coefficient of water (ADC) during focal cerebral ischemia are often reversible with reperfusion. With sustained ischemia, the magnitude of the ADC reduction generally increases with time, which could reflect increased severity of ischemic damage. Thus, a threshold in ADC reduction may exist beyond which damage can not be reversed with reperfusion. The goal of this study was to determine if such a threshold exists that is independent of the duration of ischemia in a rat model. Rats were subjected to either 30, 60, or 90 min of temporary middle cerebral artery occlusion. ADC maps acquired just before and 30 min after reperfusion were compared to histology performed after a 72 h survival period to determine the relationship between ADC reduction and final ischemic injury. Significant variability in tissue recovery was observed for the 30 min group. Regions with ADC reductions of up to 45% often recovered, while some regions not exhibiting any change in ADC during occlusion showed ischemic injury at 72 h. Similar observations were made in cortical regions of the 60 min group. In the caudate-putamen, reduced ADC was often associated with ischemic injury. For the 90 min group, results for the caudate-putamen were similar to those for the 60 min group, while reduced ADC was a much better predictor of final ischemic injury in cortical regions than it was in both the 30 and 60 min groups. Thus, no single threshold of ADC reduction that was independent of the duration of ischemia was associated with irreversible injury.
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Affiliation(s)
- A Mancuso
- Department of Neurological Surgery, Veterans Administration Medical Center and School of Medicine, University of California, San Francisco 94121, USA.
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18
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Miura I, Ohshima A, Chubachi A, Nimura T, Komatsuda A, Utsumi S, Saito M, Machii T, Nakamura S, Seto M, Miura AB. BCL6 rearrangement in a patient with mantle cell lymphoma. Ann Hematol 1997; 74:247-50. [PMID: 9200999 DOI: 10.1007/s002770050293] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We describe a patient with mantle cell lymphoma (MCL) associated with BCL6 gene rearrangement. MCL is a distinct subtype of non-Hodgkin's lymphoma characterized by CD5+, CD10-, CD20+, t(11;14)(q13;q32) and PRAD1/cyclin D1 overexpression. Although rearrangement of the BCL6 gene is the most frequent genetic change among diffuse lymphomas and some follicular lymphomas this is the first report of a patient with MCL associated with BCL6 rearrangement.
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Affiliation(s)
- I Miura
- Third Department of Internal Medicine, Akita University School of Medicine, Japan
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19
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Ohshima A, Miura I, Chubachi A, Hashimoto K, Nimura T, Utsumi S, Takahashi N, Hayashi Y, Seto M, Ueda R, Miura AB. 11q23 aberration is an additional chromosomal change in de novo acute leukemia after treatment with etoposide and mitoxantrone. Am J Hematol 1996; 53:264-6. [PMID: 8948668 DOI: 10.1002/(sici)1096-8652(199612)53:4<264::aid-ajh12>3.0.co;2-c] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We report on 2 patients with acute leukemia who had an 11q23 chromosomal aberration as an additional change after treatment with etoposide and mitoxantrone, agents that affect topoisomerase II (Topo II). One patient with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (L2) received chemotherapy, including 1,000 mg of etoposide and 75 mg of mitoxantrone. She relapsed 10 months later. Analysis at time of relapse showed a chromosomal aberration of del(11)(q23) as an additional cytogenetic change. The other patient was diagnosed with acute monoblastic leukemia (M5a) and received two autologous peripheral blood stem-cell transplantations. Her cumulative doses of etoposide and mitoxantrone were 6,000 mg and 42 mg, respectively. She also relapsed, and analysis at that time revealed del(11)(q23) as an additional chromosomal aberration. The mixed lineage leukemia/myeloid-lymphoid leukemia (MLL) gene was not rearranged in either case, making these cases distinct from previously described therapy-related leukemias caused by Topo II inhibitors. Based on these two cases, it may be that Topo II inhibitors can cause clonal evolution affecting chromosome band 11q23.
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Affiliation(s)
- A Ohshima
- Third Department of Internal Medicine, Akita University School of Medicine, Japan
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20
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Miura I, Ohshima A, Takahashi N, Hashimoto K, Nimura T, Utsumi S, Saito M, Miki T, Hirosawa S, Miura AB. A new non-random chromosomal translocation t(3;6)(q27;p21.3) associated with BCL6 rearrangement in two patients with non-Hodgkin's lymphoma. Int J Hematol 1996; 64:249-56. [PMID: 8923787 DOI: 10.1016/0925-5710(96)00496-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We describe two cases of non-Hodgkin's lymphoma associated with t(3;6)(q27;p21.3) and BCL6 rearrangement. The first case was in a 78-year old woman, whose performance status (PS) was 1, the serum lactate dehydrogenase (LDH) level was elevated, and the Ann Arbor stage was IIIA with no extra nodal lymphomatous site. The pathological diagnosis from a biopsy of the inguinal lymph node was 'malignant lymphoma (ML), follicular, small cleaved' according to the Working Formulation. Complete remission was achieved. Although she had relapse in 1992, remission was obtained again. The second case was in a 62-year old man, whose PS was 1, the serum LDH was normal, and Ann Arbor stage was IVA with the involvement of the small intestine. Histological diagnosis of the cervical lymph node was 'ML, diffuse, large cell'. Complete remission was obtained without relapse. The 3q27 translocations, found in 20-30% of non-Hodgkin's lymphoma, are unique in having multiple chromosomal translocation partners. Chromosome band 6p21.3 is one of these partner sites that may be the site of a novel gene. The two cases presented here show that this translocation is a non-random chromosomal change involving 3q27 and BCL6. Since t(3;6) was the sole karyotypic abnormality in one case, this translocation may play a role in lymphomagenesis.
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Affiliation(s)
- I Miura
- Third Department of Internal Medicine, Akita University School of Medicine, Japan.
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21
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Takahashi N, Miura I, Ohshima A, Utsumi S, Nimura T, Hashimoto K, Cyubachi A, Saitoh M, Enomoto K, Miki T, Hirosawa S, Miura A. Translocation (3;14)(q27;q11): a new variant translocation in a patient with non-Hodgkin's lymphoma of B-cell type with BCL6 rearrangement. Cancer Genet Cytogenet 1996; 90:49-53. [PMID: 8780747 DOI: 10.1016/0165-4608(96)00068-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We report a 65-year-old woman with non-Hodgkin's lymphoma (NHL) carrying a t(3;14)(q27;q11) and BCL6 rearrangement in the affected cells. She had generalized lymphadenopathy and the bone marrow was infiltrated by lymphoma cells at presentation. Histological diagnosis was "malignant lymphoma, diffuse, large cell" type according to an International Working Formulation. Chromosome analysis revealed a t(3;14)(q27;q11), which is a new variant translocation of t(3;14) (q27;q32). Southern blot analysis showed rearrangement of BCL6, JH, and TCR beta but not of TCR delta. Cosmid probe of BCL6 hybridized to 14q11 and 3q27 by fluorescence in situ hybridization (FISH). Although the band 14q11 is a locus of T-cell receptor alpha- and delta-chains (TCR alpha/delta), lymphoma cells expressed B-cell, IgGk phenotype. The findings suggest that a novel proto-oncogene in the vicinity of TCR alpha/delta is involved in this translocation.
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MESH Headings
- Aged
- Antigens, Neoplasm/analysis
- B-Lymphocytes/pathology
- Bone Marrow/immunology
- Bone Marrow/ultrastructure
- Chromosomes, Human, Pair 14/genetics
- Chromosomes, Human, Pair 14/ultrastructure
- Chromosomes, Human, Pair 3/genetics
- Chromosomes, Human, Pair 3/ultrastructure
- DNA-Binding Proteins/genetics
- Fatal Outcome
- Female
- Humans
- Immunophenotyping
- In Situ Hybridization, Fluorescence
- Karyotyping
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Neoplastic Stem Cells/immunology
- Neoplastic Stem Cells/ultrastructure
- Proto-Oncogene Mas
- Proto-Oncogene Proteins/genetics
- Proto-Oncogene Proteins c-bcl-6
- Proto-Oncogenes
- Transcription Factors/genetics
- Translocation, Genetic
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Affiliation(s)
- N Takahashi
- Third Department of Internal Medicine, Akita University School of Medicine, Japan
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22
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Takahashi N, Miura I, Ohshima A, Utsumi S, Nimura T, Hashimoto K, Saito M, Miura AB. Duplication of chromosome 9 carrying a BCR/ABL chimeric gene in Philadelphia chromosome negative chronic myeloid leukemia. Cancer Genet Cytogenet 1996; 89:166-9. [PMID: 8697426 DOI: 10.1016/0165-4608(96)00039-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We investigated a patient with Philadelphia chromosome (Ph) negative but BCR positive chronic myeloid leukemia (CML) by fluorescence in situ hybridization (FISH). In the chronic phase one chromosome 9 contained a BCR/ABL fusion gene instead of chromosome 22. Although in blast crisis, both chromosomes 9 had BCR/ABL fusion genes. This could be caused by duplication of the rearranged chromosome 9, which may have a significance similar to a double Ph chromosome. This may suggest that the critical event in CML is the formation of a BCR/ABL chimeric gene regardless of its locus in the genome.
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MESH Headings
- Chromosome Aberrations
- Chromosomes, Human, Pair 9
- Fusion Proteins, bcr-abl/genetics
- Humans
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/genetics
- Male
- Middle Aged
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Affiliation(s)
- N Takahashi
- Third Department of Internal Medicine, Akita University School of Medicine, Japan
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23
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Takahashi N, Miura I, Ohshima A, Nimura T, Hashimoto K, Hatano Y, Utsumi S, Kume M, Saito K, Kobayashi Y, Saito M, Seto M, Ueda R, Miura AB. Translocation (9;11;22)(p22;q23;q11). A new type of complex variant translocation of t(9;11)(p22;q23) with MLL rearrangement. Cancer Genet Cytogenet 1996; 88:26-9. [PMID: 8630974 DOI: 10.1016/0165-4608(95)00297-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We describe a patient with acute monocytic leukemia (M5a, FAB classification) associated with a new type of variant translocation (9;11). Southern blot analysis showed the rearrangement of the MLL (ALL-1/HRX) gene at 11q23. Fluorescence in situ hybridization (FISH) with painting probes of chromosomes 9, 11, and 22 revealed the translocation as t(9;11;22) (p22;q23;q11). This is more evidence that the production of chimeric mRNA following the translocation of the LTG9 (MLLT3/AF9) gene at 9p22 to 11q is a critical event in this leukemia subtype.
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MESH Headings
- Adult
- Blotting, Southern
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 22
- Chromosomes, Human, Pair 9
- Humans
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Monocytic, Acute/genetics
- Male
- Translocation, Genetic
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Affiliation(s)
- N Takahashi
- Third Department of Internal Medicine, Akita University School of Medicine, Japan
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24
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Nimura T, Weinstein PR, Massa SM, Panter S, Sharp FR. Heme oxygenase-1 (HO-1) protein induction in rat brain following focal ischemia. Brain Res Mol Brain Res 1996; 37:201-8. [PMID: 8738152 DOI: 10.1016/0169-328x(95)00315-j] [Citation(s) in RCA: 127] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The induction of the heme oxygenase-1 (HO-1) protein, also called HSP32, was compared to HSP70 heat shock protein induction following focal ischemia. Adult Sprague-Dawley male rats (n = 14) were subjected to either 30 min or 2 h of focal cerebral ischemia using the suture, middle-cerebral-artery (MCA) occlusion model. Controls (n = 4) had sham surgery. Following 24 h of reperfusion, subjects were killed and their brains stained immunocytochemically for HO-1 and the HSP70 heat shock proteins. One day following 30 min of ischemia, HO-1 and HSP70 staining in striatum occurred mainly in endothelial cells in infarcts and in glial cells surrounding the areas of infarction. Following the 30 min ischemia HO-1 was not induced in cortex whereas HSP70 was induced in cortical neurons in the MCA distribution. One day following 2 h of MCA ischemia, both HO-1 and HSP70 were induced in neurons in cortex in the MCA distribution. HO-1, however, was induced in glial cells throughout ipsilateral cortex, inside as well as outside the MCA distribution. This suggests that translation and/or transcription of the HO-1 and HSP70 genes are blocked in neurons and glia destined to die within infarcts, whereas translation of these stress genes continues in the endothelial cells. The duration of ischemia required to induce HSP70 in cortical neurons appears to be less than that required to induce HO-1 in cortical glia. Prolonged spreading depression and/or diffuse hemispheric ischemia may induce HO-1 in glia throughout the ipsilateral cortex via immediate early gene activation of the AP-1 site in the HO-1 promoter. Since HO-1 degrades heme, a pro-oxidant, to antioxidant molecules, the induction of HO-1 may augment oxidative defense mechanisms compromised by cerebral ischemia.
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Affiliation(s)
- T Nimura
- Department of Neurosurgery, University of California, San Francisco, USA
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25
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Utsumi S, Miura I, Takahashi N, Ohshima A, Nimura T, Hashimoto K, Chubachi A, Saito M, Takatsu H, Yamaguchi A. Bone and brain involvement in a case of diffuse large B cell lymphoma associated with t(2;3)(p12;q27). Int J Hematol 1995; 62:247-52. [PMID: 8589371 DOI: 10.1016/0925-5710(95)00410-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We report a 57-year-old male with non-Hodgkin's lymphoma (NHL) associated with t(2;3)(p12;q27). The patient showed bone lesions at presentation and brain involvement at relapse in addition to systemic lymph node swelling. Histological diagnosis was malignant lymphoma, diffuse, large cell, immunoblastic, plasmacytoid. Chromosome analysis revealed t(2;3) which is a variant type of t(3;14)(q27;q32). Fluorescence in situ hybridization (FISH) analysis disclosed splits of signals of BCL-6 gene. Among the cases reported in the literature, the common feature of t(2;3)(p11 or p12;q27) was diffuse, large cell lymphoma of B cell, kappa phenotype and four patients immunosuppressive state before lymphoma.
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Affiliation(s)
- S Utsumi
- Third Department of Internal Medicine, Akita University of Medicine, Japan
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26
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Chubachi A, Miura I, Ohshima A, Nishinari T, Nimura T, Niitsu H, Miura AB. Risk factors for hepatosplenic abscesses in patients with acute leukemia receiving empiric azole treatment. Am J Med Sci 1994; 308:309-12. [PMID: 7985717 DOI: 10.1097/00000441-199412000-00001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The authors retrospectively evaluated 63 febrile neutropenic episodes in 33 consecutive patients with leukemia who received empiric azole treatment for refractory or relapsing fever that occurred despite broad-spectrum antibiotics. In 8 patients (24%), hepatosplenic abscesses (HSA) developed. To identify the risk factors for the development of HSA, the authors compared various characteristics of febrile episodes in those with and without HSA. The risk factors included relapsed status of leukemia (P = 0.04) and Candida colonization of surveillance cultures from the throat (P = 0.03) and stool (P = 0.03). However, the duration of neutropenia, gastrointestinal symptoms, types of chemotherapy, and leukemia subtypes were not correlated with the development of HSA. Based on these results, the authors identified the high risk group for the development for HSA as patients with relapsed leukemia with fungal colonization of gastrointestinal tract during neutropenia despite empiric antifungal treatment with azoles.
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Affiliation(s)
- A Chubachi
- Third Department of Internal Medicine, Akita University School of Medicine, Japan
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27
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Chubachi A, Miura I, Ohshima A, Nimura T, Niitsu H, Miura AB. Notable clinical changes of hepatosplenic abscesses in febrile neutropenic patients receiving empiric antifungal treatment with azoles. Eur J Haematol Suppl 1994; 52:248-50. [PMID: 8005238 DOI: 10.1111/j.1600-0609.1994.tb00656.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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28
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Satoh K, Chubachi A, Niitsu H, Nimura T, Miura AB. Aspergilloma formation in a pneumatocele in a patient with acute lymphoblastic leukemia. Am J Hematol 1994; 45:351-2. [PMID: 8178812 DOI: 10.1002/ajh.2830450421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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29
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Miura I, Nishinari T, Hashimoto K, Nimura T, Miura S, Miura AB. Translocation (8;17)(p21;q21), a possible variant of t(15;17), in acute promyelocytic leukemia. Cancer Genet Cytogenet 1994; 72:75-7. [PMID: 8111744 DOI: 10.1016/0165-4608(94)90115-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We report a 64-year old man with typical features of acute promyelocytic leukemia (APL) [M3, French-American-British (FAB) classification] in whom a variant, t(8;17)(p21;q21), was detected. This is the second case of the same variant translocation to be reported. The breakpoint on 17q was similar to those described in cases with a standard translocation 15;17. Consequently, this chromosome break or rearrangement at band 17q21, rather than the recipient site of translocation of the deleted material, appears to be of crucial importance in the genesis of APL.
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Affiliation(s)
- I Miura
- Third Department of Internal Medicine, Akita University School of Medicine, Japan
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30
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Miura I, Takatsu H, Yamaguchi A, Hashimoto K, Nimura T, Nishinari T, Niitsu H, Miura AB. Standard Ph chromosome, t(9;22)(q34;q11), as an additional change in a patient with acute myelomonocytic leukemia (M4Eo) associated with inv(16)(p13q22). Am J Hematol 1994; 45:94-6. [PMID: 8250017 DOI: 10.1002/ajh.2830450118] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Abstract
We describe a 45-year-old female who developed acute myelogenous leukemia (AML) associated with a mediastinal mass. The patient achieved a complete remission accompanied by resolution of the mediastinal mass following intensive chemotherapy alone. A review of the literature disclosed ten AML patients with a mediastinal tumor; all five patients who had mediastinal granulocytic sarcoma treated by local irradiation prior to developing AML, eventually relapsed as frank leukemia and died soon afterwards. On the other hand, three of the other five patients who simultaneously developed both a mediastinal tumor and overt AML achieved complete remission with combination chemotherapy. In conclusion, intensive chemotherapy should be considered for a patient with granulocytic sarcoma of the mediastinum, irrespective of the concomitant leukemia.
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Affiliation(s)
- A Chubachi
- Third Department of Internal Medicine, Akita University School of Medicine, Japan
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32
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Miura I, Cyubachi A, Hashimoto K, Nishinari T, Nimura T, Miura AB. [Long term follow-up of three cases of acute myeloid leukemia associated with inv(16)(p13q22)]. Rinsho Ketsueki 1993; 34:942-5. [PMID: 8411649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Three cases of acute myeloid leukemia associated with inv(16(p13q22) were followed up for over 5 years. This chromosome aberration is generally thought to be a good prognostic factor. However, it is also reported that these patients are apt to relapse and have relatively high frequency of central nervous system (CNS) involvement. The first patient (M4Eo), who died of gastric cancer about 5 years after the initial treatment without frank relapse, did not have prophylactic therapy for CNS involvement. The second patient (M5b) developed meningeal leukemia and myeloblastoma of the brain, showing similar findings on CT scan to cases reported by Holms et al. He was treated successfully with whole brain irradiation and intrathecal injection of ara-C and MTX, and intracranial tumor disappeared on CT and MR imaging. He has been enjoying a good quality of life without any complication for over ten years after the initial diagnosis. The third patient (M4Eo) relapsed once but reentered complete remission with relative ease and we used an intrathecal injection prophylactically. This case has been followed up as an outpatient for more than 5 years since onset. On the basis of these findings, it may be concluded that these leukemia patients with inv(16)(p13q22) have good prognosis and can be cured with chemotherapy.
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Affiliation(s)
- I Miura
- Third Department of Internal Medicine, Akita University School of Medicine
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33
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Miura I, Hamanaka SC, Hashimoto K, Nishinari T, Nimura T, Mamiya S, Miura AB. [Proliferation of micromegakaryocytes in acute myelocytic leukemia associated with 5 q- as the sole karyotypic abnormality]. Rinsho Ketsueki 1993; 34:478-83. [PMID: 8510336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The authors report a de novo AML (M2) patient associated with 5q- as the sole karyotypic abnormality. A 76-year-old woman was referred to our hospital because of anemia and leukocytosis. On examination a neck lymph node was enlarged, but neither the liver nor the spleen could be palpated. The hemoglobin level was 7.1g/dl, the mean corpuscular volume 102fl and the white-cell count was 256.1 x 10(3)/microliters with 87% blast cells. The platelet count was 10.9 x 10(4)/microliters. The bone marrow was hypercellular with 79.8% blast cells and showed dysmegakaryocytopoietic features (hypolobulation, multiple separated nuclei and micromegakaryocytes). Blast cells gave a positive reaction for peroxidase and alpha NB esterase which was not blocked by NaF. The diagnosis of AML (M2) was made but she died before chemotherapy. Autopsy revealed general hemorrhagic tendency and leukemic cell infiltration. Chromosome analysis of the bone marrow showed 46,XX,del(5) (q13q31). Electron micrographs revealed increase of micromegakaryocytes as small as myelocytes and aggregation of demarcation membranes in some megakaryocytes. This may suggest that some molecular changes, instead of karyotypic evolution, contributed to a leukemic transition from the 5q- syndrome to AML with 5q- as the sole abnormality.
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Affiliation(s)
- I Miura
- Third Department of Internal Medicine, Akita University School of Medicine
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34
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Miura I, Nishinari T, Hashimoto K, Nimura T, Takatsu H, Niitsu H, Hirokawa M, Kuwayama A, Nishimura S, Miura AB. Ph+ acute myelogenous leukemia with t(7;11)(p15;p15) and clonal evolution in relapse after bone marrow transplantation. Acta Haematol 1993; 90:148-50. [PMID: 8291375 DOI: 10.1159/000204397] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A 20-year-old female with Ph+ acute myelogenous leukemia (M2) associated with t(7;11)(p15;p15) is reported. Bone marrow aspirates were hypercellular with leukemic cells including Auer rods. Chromosome analysis showed t(7;11) and the Ph chromosome. After complete remission, normal karyotype was restored. Normal male karyotypic cells replaced the bone marrow following allogeneic bone marrow transplantation from her brother. On day 358, cytogenetic study at relapse revealed 14q+ as an additional change and clearly showed that the abnormal clone was derived from the patient, because metaphases with XX were all of abnormal karyotype and those with XY were normal.
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MESH Headings
- Adult
- Bone Marrow Transplantation
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 7
- Female
- Humans
- Karyotyping
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/therapy
- Recurrence
- Translocation, Genetic
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Affiliation(s)
- I Miura
- Third Department of Internal Medicine, Akita University School of Medicine, Japan
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35
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Takahashi N, Chubachi A, Watanabe S, Nishinari T, Nimura T, Imai H, Fukushima Y, Miura AB. [Isolated cerebellar tumor formation in a patient with blastic crisis of chronic myelogenous leukemia]. Rinsho Ketsueki 1992; 33:1257-62. [PMID: 1433948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A 42-year-old male was diagnosed as having Ph-positive chronic myelogenous leukemia (CML) in 1988. He had been treated with ranimustine and interferon alpha. In April 1990, he was admitted to our hospital because of hemorrhagic diathesis. Blood counts revealed a white blood cell count of 319,200/microliters with 12 per cent blasts, a hemoglobin level of 9.2 g/dl, and a platelet count of 48,000/microliters. The bone marrow aspiration revealed hypercellularity with 68.2 per cent blasts, and chromosomal analysis showed 48, XY, +8, double Ph. A combination chemotherapy containing vindesine, cytarabine and prednisolone was administered. Four days later, he suddenly complained of headache and vertigo. CT scan of the brain showed a high density area at the cerebellar vermis. He was then treated with intensive combination chemotherapy including enocitabine, daunomycin, 6-mercaptopurine and prednisolone. He attained a hematological response and clinical improvement temporarily, as the cerebellar tumor regressed. In September he had headache and vertigo again, and CT scan revealed a rapid increase in size of the cerebellar tumor. Local irradiation with total doses of 19 Gy brought about a partial resolution of the lesion, and relief from the symptoms. In November, his hematological conditions deteriorated gradually and he died of brain hemorrhage on November 22, 1990. Post-mortem examination disclosed a 1 x 1 cm sized mass in the cerebellar vermis which showed a fibrous change surrounded with hemosiderin-laden macrophages microscopically. We reviewed the eight reported cases of CML with intracranial tumors, and discussed the factors which had contributed to the prolongation of survival in our patient.
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Affiliation(s)
- N Takahashi
- Third Department of Internal Medicine, Akita University School of Medicine
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Chubachi A, Ohtani H, Sakuyama M, Nimura T, Mamiya S, Saitoh M, Watanuki T, Miura AB. Diffuse large cell lymphoma occurring in a patient with Waldenström's macroglobulinemia. Evidence for the two different clones in Richter's syndrome. Cancer 1991; 68:781-5. [PMID: 1906774 DOI: 10.1002/1097-0142(19910815)68:4<781::aid-cncr2820680420>3.0.co;2-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The authors report a 60-year-old man with Richter's syndrome, or diffuse large cell lymphoma (DLCL) occurring in a patient with either chronic lymphocytic leukemia (CLL) or Waldenström's macroglobulinemia (WM). Surface marker analysis revealed that the WM showed mu kappa surface immunoglobulin (Ig) chains, and that the DLCL showed mu lambda Ig chains. Flow cytometric DNA analysis demonstrated DNA content differences between WM and DLCL, the former diploid and the latter aneuploid. The current study suggests that Richter's syndrome derives from two independent B-cell malignancies.
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Affiliation(s)
- A Chubachi
- Third Department of Internal Medicine, Akita University School of Medicine, Japan
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37
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Hori M, Nimura T, Miura M, Fujisawa T, Satou T, Morimoto T, Moriya S. Development of an Inspection Robot for Penstocks. J Robot Mechatron 1990. [DOI: 10.20965/jrm.1990.p0373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
An inspection robot has been developed jointly with the Electric Power Development Co. for the purpose of inspecting the corrosion and coating deterioration of penstocks (3500 to 5000mm) for electric power generation, particularly their sloping sections. This robot is a simplified device which, equipped with a centering apparatus consisting of cylinders, travels in a spiral fashion by pressing its wheels along the surface of a pipe, and is capable of propelling itself to climb the sloping sections of penstocks after passing through their bends and reducers. After testing with penstocks and twice-conducted field tests, a working model has been completed, and it was even possible to get the model to perform the additional task of repairing. We therefore present here a complete report.
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Nimura T, Okada M, Shimizu M, Kawabe M, Itoh T, Iwasaki M, Kimura H, Takeuchi T. [How to discriminate between vibration syndrome and local fatigue of motorcyclists]. Ann Physiol Anthropol 1990; 9:329-33. [PMID: 2073298 DOI: 10.2114/ahs1983.9.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Motorcyclists who work in some offices sometimes complained of coldness, pain and numbness of upper limbs. We studied how to discriminate between vibration syndrome and local fatigue of the motorcyclists. Subjects are 42 motorcyclists of an office in Aichi prefecture. 25 of them held several letters in their left hand when they delivered the letters. They complained of coldness, pain and numbness in the left upper limbs more than in the right limbs (p less than 0.01). We think that it is the local fatigue rather than the disorder of vibration syndrome that causes such symptoms. So it is very important to recognize the existence of local fatigue in order to know how to discriminate between vibration syndrome and local fatigue of the motorcyclists.
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Affiliation(s)
- T Nimura
- First Department of Internal Medicine, Nagoya City University School of Medicine
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Hirokawa M, Takatsu H, Niitsu H, Nishinari T, Nimura T, Itoh T, Chubachi A, Miura I, Yoshida K, Endo Y. Serum tumor necrosis factor-alpha levels in allogeneic bone marrow transplant recipients with acute leukemia. TOHOKU J EXP MED 1989; 159:237-44. [PMID: 2623665 DOI: 10.1620/tjem.159.237] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We determined the serum levels of tumor necrosis factor-alpha (TNF) in allogeneic bone marrow transplant recipients in order to evaluate the relationship between TNF and graft-versus-host disease (GVHD). Eight patients with acute leukemia receiving an HLA-identical marrow graft were studied. Samples from healthy subjects and pretransplant recipients were all negative for TNF. Six of eight patients had detectable levels of TNF in serum after transplantation. All three patients with acute GVHD, and three of five patients without acute GVHD had elevated TNF levels in serum. Among the patients with increased TNF levels, documented infection was demonstrated in only one patient, with a clinical diagnosis of B19 parvovirus infection. Serum TNF levels were elevated when the WBC counts were more than 2,000/microliters. However, serum concentrations of TNF significantly correlated with body temperature. Although we could not conclude definitely that serum TNF levels correlated with severity of GVHD, it was suggested that TNF may be produced as a result of latent infections or immunological reaction against non-HLA allogeneic antigens.
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Affiliation(s)
- M Hirokawa
- Third Department of Internal Medicine, Akita University School of Medicine
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Hirokawa M, Fukuda M, Nimura T, Miura I, Mamiya S, Yoshida K, Miura AB. [Severe hypophosphatemia in a patient with chronic myeloid leukemia in blast crisis]. Rinsho Ketsueki 1987; 28:228-32. [PMID: 3471987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Mamiya S, Nimura T, Niitsu H, Endo Y, Miura A. [Postpartum factor VIII inhibitor associated with primary biliary cirrhosis: a case report]. Nihon Naika Gakkai Zasshi 1986; 75:40-5. [PMID: 3084689 DOI: 10.2169/naika.75.40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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42
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Fukuda M, Nimura T, Miura I, Mamiya S, Takatsu H, Nakayama Y, Kimura Y, Miura A, Watanuki T. [Hypercalcemia after the conditioning of allogeneic bone marrow transplantation in a patient with Burkitt's lymphoma]. Rinsho Ketsueki 1985; 26:951-6. [PMID: 3906175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Matsumoto H, Hiki S, Sone T, Nimura T. Multidimensional representation of personal quality of vowels and its acoustical correlates. ACTA ACUST UNITED AC 1973. [DOI: 10.1109/tau.1973.1162507] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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46
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Tanaka N, Tanaka H, Takeda M, Nimura T, Kanehisa T, Terashi S. Cardiomyopathy in myotonic dystrophy. A light and electron microscopic study of the myocardium. Jpn Heart J 1973; 14:202-12. [PMID: 4542274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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47
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Nimura T, Furukawa T, Inoue M, Kimura K, Kato T. [Spatial phase cardiophonogram. 2]. Rinsho Byori 1971; 19:Suppl:511. [PMID: 5168172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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48
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Orita S, Minami S, Nimura T. [Hospitals for cardiovascular diseases in the U.S.A. and European countries. 3]. Iryo 1971; 25:471-82. [PMID: 5558798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Orita S, Minami S, Nimura T. [Report on hospitals for cardiovascular diseases in the U.S.A. and European countries. 2]. Iryo 1971; 25:363-85. [PMID: 5115166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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50
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Orita S, Minami S, Nimura T. [Report on hospitals for cardiovascular diseases in the U.S.A. and European countries. 1]. Iryo 1971; 25:279-91. [PMID: 5554283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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