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1.
Science ; 367(6476): 431-435, 2020 01 24.
Article in English | MEDLINE | ID: mdl-31974252

ABSTRACT

The plant embryonic cuticle is a hydrophobic barrier deposited de novo by the embryo during seed development. At germination, it protects the seedling from water loss and is, thus, critical for survival. Embryonic cuticle formation is controlled by a signaling pathway involving the ABNORMAL LEAF SHAPE1 subtilase and the two GASSHO receptor-like kinases. We show that a sulfated peptide, TWISTED SEED1 (TWS1), acts as a GASSHO ligand. Cuticle surveillance depends on the action of the subtilase, which, unlike the TWS1 precursor and the GASSHO receptors, is not produced in the embryo but in the neighboring endosperm. Subtilase-mediated processing of the embryo-derived TWS1 precursor releases the active peptide, triggering GASSHO-dependent cuticle reinforcement in the embryo. Thus, a bidirectional molecular dialogue between embryo and endosperm safeguards cuticle integrity before germination.


Subject(s)
Endosperm/physiology , Germination , Seeds/physiology , Amino Acid Sequence , Endosperm/cytology , Endosperm/metabolism , Ligands , Plant Proteins/chemistry , Plant Proteins/metabolism , Protein Kinases/chemistry , Protein Kinases/metabolism , Seeds/cytology , Seeds/metabolism , Serine Endopeptidases/chemistry , Serine Endopeptidases/metabolism , Signal Transduction , Nicotiana/growth & development , Nicotiana/metabolism
2.
Sci Adv ; 4(11): eaau1354, 2018 11.
Article in English | MEDLINE | ID: mdl-30474058

ABSTRACT

Organogenesis is a self-organizing process of multiple cells in three-dimensional (3D) space, where macroscopic tissue deformations are robustly regulated by multicellular autonomy. It is clear that this robust regulation requires cells to sense and modulate 3D tissue formation across different scales, but its underlying mechanisms are still unclear. To address this question, we developed a versatile computational model of 3D multicellular dynamics at single-cell resolution and combined it with the 3D culture system of pluripotent stem cell-derived optic-cup organoid. The complementary approach enabled quantitative prediction of morphogenesis and its corresponding verification and elucidated that the macroscopic 3D tissue deformation is fed back to individual cellular force generations via mechanosensing. We hereby conclude that mechanical force plays a key role as a feedback regulator to establish the robustness of organogenesis.


Subject(s)
Models, Theoretical , Morphogenesis , Organ Culture Techniques/methods , Organogenesis , Retina/cytology , Stress, Mechanical , Humans
3.
J Musculoskelet Neuronal Interact ; 17(1): 433-443, 2017 03 01.
Article in English | MEDLINE | ID: mdl-28250247

ABSTRACT

OBJECTIVES: The purpose of this study was to examine the effects of long-term wheel-running on tibia bone properties in T2DM Otsuka Long-Evans Tokushima Fatty (OLETF) rats. METHODS: Ten five-week-old male OLETF rats were used as experimental animals and 5 Long-Evans Tokushima Otsuka (LETO) rats as controls. Half of OLETF rats performed daily voluntary wheel-running for 17 months (OLETF-EXE), while neither the remainder of OLETF nor LETO rats had exercise. At the end of experiment, in addition to serum biochemical and bone formation/resorption marker analyses, bone mass, trabecular bone microarchitecture and cortical bone geometry were analyzed in left tibia, and bone mechanical strength of right tibia was measured. RESULTS: Tibia bone mass, trabecular bone microarchitecture, cortical bone geometry and bone mechanical strength deteriorated in diabetic OLETF rats. However, such deterioration was obviously attenuated in OLETF-EXE rats, which maintained normal levels of blood glucose, HbA1c and blood urea nitrogen. CONCLUSIONS: Daily wheel-running could prevent the deterioration of bone properties in OLETF rats. This would be induced mainly by suppressing the development of T2DM. Regular physical exercise may be a potent strategy for preventing not only the development of diabetes but also the deterioration of bone properties in patients with chronic T2DM.


Subject(s)
Bone Density/physiology , Cortical Bone/diagnostic imaging , Diabetes Mellitus, Type 2/diagnostic imaging , Diabetes Mellitus, Type 2/therapy , Disease Models, Animal , Physical Conditioning, Animal/trends , Animals , Cortical Bone/metabolism , Diabetes Mellitus, Type 2/blood , Male , Rats , Rats, Inbred OLETF , Rats, Long-Evans , Time Factors , X-Ray Microtomography/trends
5.
Horm Metab Res ; 47(4): 253-8, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25105541

ABSTRACT

Advanced glycation end products (AGEs) decrease adiponectin expression and suppress insulin signaling in cultured adipocytes through the interaction with a receptor for AGEs (RAGE) via oxidative stress generation. We have recently found that high-affinity DNA aptamer directed against AGE (AGE-aptamer) prevents the progression of experimental diabetic nephropathy by blocking the harmful actions of AGEs in the kidney. This study examined the effects of AGE-aptamer on adipocyte remodeling, AGE-RAGE-oxidative stress axis, and adiponectin expression in fructose-fed rats. Although AGE-aptamer treatment by an osmotic mini pump for 8 weeks did not affect serum insulin levels, it significantly decreased average fasting blood glucose and had a tendency to inhibit body weight gain in fructose-fed rats. Furthermore, AGE-aptamer significantly suppressed the increase in adipocyte size and prevented the elevation in AGEs, RAGE, and an oxidative stress marker, 8-hydroxydeoxyguanosine (8-OHdG), levels in adipose tissues of fructose-fed rats at 14-week-old, while it restored the decrease in adiponectin mRNA levels. Our present study suggests that AGE-aptamer could improve glycemic control and prevent adipocyte remodeling in fructose-fed rats partly by suppressing the AGE-RAGE-mediated oxidative stress generation. AGE-aptamer might be a novel therapeutic strategy for fructose-induced metabolic derangements.


Subject(s)
Adipocytes/pathology , Aptamers, Nucleotide/administration & dosage , Blood Glucose/analysis , Fructose/administration & dosage , Glycation End Products, Advanced/antagonists & inhibitors , Receptor for Advanced Glycation End Products/antagonists & inhibitors , Adipocytes/drug effects , Adiponectin/genetics , Animals , Cell Size/drug effects , Diet , Gene Expression/drug effects , Glycation End Products, Advanced/genetics , Insulin Resistance , Male , Oxidative Stress/drug effects , Rats , Rats, Wistar , Real-Time Polymerase Chain Reaction , Weight Gain/drug effects
6.
Climacteric ; 18(3): 426-30, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25340263

ABSTRACT

Advanced glycation endproducts (AGEs) and their receptor (RAGE) play a role in vascular complications in diabetes. We have previously shown that 17ß-estradiol at 10 nmol/l, a nearly identical plasma concentration to that during mid-pregnancy, up-regulates RAGE expression in endothelial cells. The finding might suggest the involvement of 17ß-estradiol in the deterioration of vascular complications in diabetes during pregnancy. However, the effects of the selective estrogen receptor modulator, bazedoxifene, on oxidative and inflammatory reactions in AGEs-exposed endothelial cells remain unknown. In this study, we addressed the issue. Ten nmol/l 17ß-estradiol increased RAGE and monocyte chemoattractant protein-1 (MCP-1) gene and protein expression in human umbilical vein endothelial cells (HUVECs), both of which were blocked by 10 nmol/l bazedoxifene. Bazedoxifene at 10 nmol/l also significantly inhibited the AGEs-induced superoxide generation, RAGE and MCP-1 gene and protein expression in HUVECs. The present study suggests that blockade of the AGEs-RAGE axis by bazedoxifene might be a novel therapeutic target for preventing vascular damage in diabetes, especially in postmenopausal women.


Subject(s)
Chemokine CCL2/metabolism , Human Umbilical Vein Endothelial Cells/metabolism , Indoles/administration & dosage , Receptor for Advanced Glycation End Products/metabolism , Selective Estrogen Receptor Modulators/administration & dosage , Superoxides/chemistry , Cells, Cultured , Chemokine CCL2/genetics , Humans , Oxidative Stress/drug effects , Receptor for Advanced Glycation End Products/genetics
7.
Rev Sci Instrum ; 85(2): 02A737, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24593471

ABSTRACT

Our previous study by two dimension in real space and three dimension in velocity space-particle in cell model shows that the curvature of the plasma meniscus causes the beam halo in the negative ion sources. The negative ions extracted from the periphery of the meniscus are over-focused in the extractor due to the electrostatic lens effect, and consequently become the beam halo. The purpose of this study is to verify this mechanism with the full 3D model. It is shown that the above mechanism is essentially unchanged even in the 3D model, while the fraction of the beam halo is significantly reduced to 6%. This value reasonably agrees with the experimental result.


Subject(s)
Models, Theoretical , Nuclear Reactors/instrumentation , Plasma Gases
8.
Eur J Neurol ; 21(3): 419-26, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24261412

ABSTRACT

BACKGROUND AND PURPOSE: The characteristics of reverse magnetic resonance angiography and diffusion-weighted imaging (MRA-DWI) mismatch (RMM), defined as a large DWI lesion in the absence of major artery occlusion (MAO), remain unknown, especially in patients treated with intravenous recombinant tissue plasminogen activator (rt-PA). METHODS: Patients with stroke in the middle cerebral artery territory were included. Early ischaemic changes (EIC) were assessed with the Alberta Stroke Program Early CT Score on DWI (DWI-ASPECTS). All patients were divided into four groups based on the presence of MAO and a DWI-ASPECTS cut-off value of <7. RMM was defined as DWI-ASPECTS <7 without MAO. Clinical characteristics, symptomatic intracerebral hemorrhage (sICH) and favorable functional outcome (modified Rankin Scale score 0-2) at 90 days were compared amongst the four groups. RESULTS: Of the 486 patients enrolled (167 women, median age 74 years, median initial National Institutes of Health Stroke Scale score 13), reverse MRA-DWI mismatch was observed in 24 (5%). Of the clinical characteristics, cardioembolism was the only factor that was independently associated with RMM [odds ratio (OR) 5.49, 95% confidence interval (CI) 1.25-24.1]. Multivariable analyses revealed that patients with RMM more commonly had sICH than those with DWI-ASPECTS ≥ 7 irrespective of the presence (OR 5.44, 95% CI 1.13-26.1) or absence (13.1, 2.07-83.3) of MAO, and they had a more favorable functional outcome than those with DWI-ASPECTS < 7 plus MAO (7.45, 2.39-23.2). CONCLUSION: RMM was observed in 5% of patients treated with rt-PA and associated with cardioembolism. Patients with RMM may benefit from thrombolysis compared with those with EIC with MAO, although increment in the rate of sICH is a concern.


Subject(s)
Diffusion Magnetic Resonance Imaging , Fibrinolytic Agents/administration & dosage , Magnetic Resonance Angiography , Stroke/diagnosis , Stroke/drug therapy , Tissue Plasminogen Activator/administration & dosage , Administration, Intravenous , Aged , Aged, 80 and over , Female , Humans , Logistic Models , Male , Middle Aged , Predictive Value of Tests , Registries , Retrospective Studies , Severity of Illness Index , Thrombolytic Therapy , Treatment Outcome
9.
Bone Marrow Transplant ; 48(1): 94-8, 2013 Jan.
Article in English | MEDLINE | ID: mdl-22750996

ABSTRACT

Hyperbilirubinemia in the early phase after allogeneic hematopoietic SCT (HSCT) is due to various causes. One of the most important causes of hyperbilirubinemia is veno-occlusive disease/sinusoidal obstructive syndrome (VOD/SOS). However, the prognosis of patients who are clinically diagnosed as SOS varies. We retrospectively evaluated 82 patients who underwent their first allogeneic HSCT. GVHD prophylaxis was a combination of short-term MTX and CsA (n=77) or tacrolimus (n=5). Thirty-three patients developed hyperbilirubinemia, with a bilirubin level of at least 2 mg/dL, within 20 days after HSCT. Of these patients, 24 were diagnosed as VOD/SOS using the modified Seattle criteria. Twenty-six recovered to a bilirubin level of <2 mg/dL. We focused on the serum alkaline phosphatase/total bilirubin ratio (ALP/TB) at the onset of hyperbilirubinemia and found that it significantly predicted the recovery from hyperbilirubinemia. OS was significantly higher in patients with a lower ALP/TB ratio (P=0.00056). In addition, a lower ALP/TB ratio was associated with better survival even in patients who were clinically diagnosed as SOS (P<0.001). The ALP/TB ratio at the onset of hyperbilirubinemia may be a useful predictor for the prognosis of hyperbilirubinemia and SOS early after HSCT.


Subject(s)
Alkaline Phosphatase/blood , Bilirubin/blood , Hematopoietic Stem Cell Transplantation/adverse effects , Hepatic Veno-Occlusive Disease/diagnosis , Hyperbilirubinemia/etiology , Liver/physiopathology , Adolescent , Adult , Aged , Algorithms , Early Diagnosis , Female , Hepatic Veno-Occlusive Disease/epidemiology , Hepatic Veno-Occlusive Disease/etiology , Hepatic Veno-Occlusive Disease/physiopathology , Humans , Hyperbilirubinemia/blood , Incidence , Japan/epidemiology , Male , Middle Aged , Predictive Value of Tests , Retrospective Studies , Survival Analysis , Transplantation, Homologous , Young Adult
10.
Vet Microbiol ; 162(1): 219-23, 2013 Feb 22.
Article in English | MEDLINE | ID: mdl-23107657

ABSTRACT

We previously reported that prior porcine circovirus type 2 (PCV2) infection potentiates the severity of clinical signs, lung lesions, and fecal shedding and tissue dissemination of Salmonella enterica serovar Choleraesuis in infected pigs. Here, we evaluated whether PCV2 vaccination is effective in reducing fecal shedding and tissue dissemination of S. Choleraesuis and improving clinical signs associated with PCV2 and S. Choleraesuis infection in 15 Cesarean-derived, colostrum-deprived pigs randomly assigned to 3 groups (n=5/group). The vaccinated and co-infected (VAC-COINF) group received 2 ml of a commercial PCV2 vaccine at age 3 weeks. The VAC-COINF and co-infected (COINF) groups were inoculated intranasally with PCV2 and S. Choleraesuis at 5 and 7 weeks of age, respectively. The CONTROL group pigs received a similar volume of PBS for sham-vaccination and sham-inoculation. PCV2 vaccination clearly reduced PCV2 DNA load in the serum and postmortem tissue samples and decreased PCV2 antigen levels in tissue samples of the VAC-COINF group. After S. Choleraesuis infection, the incidence of several clinical signs increased in the VAC-COINF group compared to that in the COINF group. The microscopic lung lesions and weight gain, fecal shedding and tissue dissemination of S. Choleraesuis except in the spleen were not significantly different in the VAC-COINF and COINF groups. Thus, PCV2 vaccination reduced PCV2 in the S. Choleraesuis and PCV2 coinfection model and the effects on S. Choleraesuis were minimal.


Subject(s)
Circoviridae Infections/prevention & control , Circovirus/immunology , Salmonella Infections, Animal/virology , Salmonella enterica/immunology , Swine Diseases/microbiology , Swine Diseases/prevention & control , Viral Vaccines/pharmacology , Animals , Circoviridae Infections/immunology , Circoviridae Infections/veterinary , Circoviridae Infections/virology , Circovirus/genetics , Coinfection/immunology , Coinfection/microbiology , Coinfection/prevention & control , Coinfection/virology , Colostrum/microbiology , DNA, Viral/analysis , Feces/microbiology , Female , Pregnancy , Random Allocation , Salmonella Infections, Animal/immunology , Salmonella Infections, Animal/microbiology , Swine , Swine Diseases/immunology , Swine Diseases/virology , Viral Vaccines/immunology
11.
Bone Marrow Transplant ; 48(5): 698-702, 2013 May.
Article in English | MEDLINE | ID: mdl-23042494

ABSTRACT

Various biomarkers have been investigated with regard to their ability to predict the outcome of allogeneic hematopoietic SCT (HSCT). In this study, we retrospectively reviewed 90 recipients who received HSCT between 2007 and 2011 in our institution, and evaluated the predictive value of the baseline serum C-reactive protein (CRP) levels just before the initiation of conditioning for transplant-related complications after allogeneic HSCT. A receiver-operating characteristic curve revealed that the baseline serum CRP levels had an excellent predictive value for non-relapse mortality (NRM), with an area under the curve of 0.83. The sensitivity and specificity for NRM were 80% and 87%, respectively, with a cutoff of 0.6 mg/dL. With this cutoff value, multivariate analyses revealed that a higher baseline CRP level was an independent risk factor for NRM (HR 6.21, P<0.01), grade III-IV acute GVHD (HR 3.91, P=0.03) and poor overall survival (HR 3.27, P=0.0018). On the other hand, the baseline CRP level did not predict infectious events. These findings suggested that CRP levels before conditioning may be a useful predictive biomarker for poor survival.


Subject(s)
C-Reactive Protein/metabolism , Hematopoietic Stem Cell Transplantation/methods , Acute Disease , Adolescent , Adult , Aged , Biomarkers/blood , C-Reactive Protein/analysis , Female , Graft vs Host Disease/blood , Graft vs Host Disease/etiology , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Leukemia/blood , Leukemia/drug therapy , Leukemia/surgery , Male , Middle Aged , Predictive Value of Tests , Prognosis , Retrospective Studies , Transplantation Conditioning/adverse effects , Transplantation Conditioning/methods , Young Adult
12.
J Vasc Interv Neurol ; 5(supp): 1-5, 2012 Aug.
Article in English | MEDLINE | ID: mdl-23230457

ABSTRACT

Intracerebral hemorrhage (ICH) is a major cause of morbidity and mortality in Japan. Seventeen Japanese institutions are participating in the Antihypertensive Treatment for Acute Cerebral Hemorrhage (ATACH) II Trial (ClinicalTrials.gov no. NCT01176565; UMIN 000006526). This phase III trial is designed to determine the therapeutic benefit of early intensive systolic blood pressure (BP) lowering for acute hypertension in ICH patients. This report explains the long run-up to reach the start of patient registration in ATACH II in Japan, including our preliminary study, a nationwide survey on antihypertensive treatment for acute ICH patients, a multicenter study for hyperacute BP lowering (the SAMURAI-ICH study), revision of the official Japanese label for intravenous nicardipine, and construction of the infrastructure for the trial.

13.
Transpl Infect Dis ; 14(4): 364-73, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22469427

ABSTRACT

We retrospectively investigated L-index, which evaluates both the intensity and duration of lymphopenia after allogeneic hematopoietic stem cell transplantation (HSCT) (n = 50). L-index was defined as the area over the lymphocyte curve during lymphopenia (absolute lymphocyte count < 700/µL). We calculated the L-index from the start of conditioning to day 30 - L-index(30) - and to day 100 - L-index(100) - after HSCT. Multivariate analysis revealed that human leukocyte antigen mismatched donor, female gender, and non-lymphoid disease were significantly associated with high L-index(30). Grade III-IV acute graft-versus-host disease, alemtuzumab-containing regimen, and non-lymphoid disease were identified as independent significant factors for high L-index(100). Cytomegalovirus (CMV) antigenemia was detected > 3 cells/2 slides by C10/11 method in 30 patients (CMV-AG ≥ 3 group) and was not detected in 20 patients (CMV-AG < 3 group). Although no significant difference was seen in absolute lymphocyte count on day 30 between the 2 groups, the L-index(30) was significantly higher in the CMV-AG ≥ 3 group than in the CMV-AG < 3 group (P = 0.050). L-index(30) was identified as an independent factor on CMV reactivation in multivariate analysis, when it was treated as a dichotomous variable with a cut-off value of 22,318, determined by receiver operating characteristic curve analysis. In conclusion, both the intensity and duration of lymphopenia in early phase after HSCT evaluated on the basis of L-index(30) showed significant association with CMV reactivation.


Subject(s)
Cytomegalovirus Infections/virology , Cytomegalovirus/physiology , Hematopoietic Stem Cell Transplantation/adverse effects , Lymphocyte Count/standards , Lymphopenia/diagnosis , Virus Activation , Adolescent , Adult , Area Under Curve , Female , Humans , Male , Middle Aged , Retrospective Studies , Transplantation Conditioning , Transplantation, Homologous/adverse effects , Young Adult
14.
Rev Sci Instrum ; 83(2): 02A723, 2012 Feb.
Article in English | MEDLINE | ID: mdl-22380232

ABSTRACT

The modeling and analysis of a negative ion source is proceeding by using a 2D particle-in-cell simulation. The effect of the H(-) ion production on the plasma grid (PG) surface is investigated. It is shown that with the increase of H(-) ions per time step, the H(-) ion current density is enhanced, while the electron current density decreases with increasing the H(-) production rate on the PG surface. These results agree well with the experimental results observed in typical negative ion sources. Moreover, it is found that plasma quasi-neutrality is held mainly by both H(+) and H(-) ions in the bulk plasma around the PG.

15.
Transpl Infect Dis ; 14(4): E7-12, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22340704

ABSTRACT

Although the reactivation of varicella zoster virus (VZV) is a common complication after allogeneic hematopoietic stem cell transplantation (HSCT), VZV meningoencephalitis is a rare life-threatening infectious disease after HSCT. We describe here a patient who developed VZV meningoencephalitis 2 years after human leukocyte antigen-matched unrelated HSCT for acute myeloblastic leukemia. She developed chronic graft-versus-host disease, and cyclosporine (CSA) was continued until 17 months after HSCT. Low-dose acyclovir (ACV) at 200 mg/day was administered to prevent the reactivation of VZV from day -7 to the termination of CSA. At 22 months, she suddenly developed fever, loss of consciousness, and seizure, with generalized skin rash. A high level of VZV DNA was detected in her cerebrospinal fluid (CSF). She was diagnosed to have VZV meningoencephalitis. Intravenous ACV at 30 mg/kg/day was given for 2 months. Although loss of consciousness was quickly resolved, some neurologic symptoms persisted. She did not have any known risk factors for VZV reactivation. Therefore, we should keep in mind that any HSCT recipient may develop VZV meningoencephalitis, and examination of CSF for VZV infection with an empiric administration of ACV may be recommended for HSCT recipients with central nervous system symptoms, even in the absence of skin manifestations.


Subject(s)
Encephalitis, Varicella Zoster/drug therapy , Hematopoietic Stem Cell Transplantation/adverse effects , Herpesvirus 3, Human/isolation & purification , Transplantation, Homologous/adverse effects , Acyclovir/administration & dosage , Acyclovir/therapeutic use , Adult , Antiviral Agents/administration & dosage , Antiviral Agents/therapeutic use , Cerebrospinal Fluid/virology , Encephalitis, Varicella Zoster/virology , Female , Herpesvirus 3, Human/drug effects , Herpesvirus 3, Human/genetics , Humans , Treatment Outcome , Virus Activation
16.
Bone Marrow Transplant ; 46(11): 1450-4, 2011 Nov.
Article in English | MEDLINE | ID: mdl-21243022

ABSTRACT

Autologous hematopoietic SCT (ASCT) has been investigated as salvage therapy for refractory systemic lupus erythematosus (SLE). Although immune recovery after ASCT with in vitro purging of lymphocytes has been extensively studied, little information is available about immune recovery after ASCT without in vitro purging. Therefore, we analyzed the immune recovery of a patient who successfully underwent ASCT without in vitro purging for refractory SLE. In addition to the numbers of PBL subsets, T-cell receptor rearrangement excision circles (TRECs) and the T-cell receptor repertoire diversity of both CD4+ and CD8+ T cells were sequentially analyzed. All SLE-related symptoms disappeared within 3 months after ASCT and the serum anti-dsDNA Ab became undetectable. The number of CD4+CD45RO+ memory T cells remained lower than that in healthy adult controls, but the number of CD4+CD45RA+ naïve T cells showed a rapid increase after ASCT. TRECs of both CD4+ and CD8+ T cells were strongly suppressed before ASCT, but consistently increased after ASCT. The T-cell receptor repertoire of CD8+ T cells was skewed before ASCT, but the diversity recovered after ASCT. ASCT with the reinfusion of a large number of autologous T cells did not impair the recovery of naive T cells or resetting of the immune system.


Subject(s)
Lupus Erythematosus, Systemic/immunology , Lupus Erythematosus, Systemic/therapy , Peripheral Blood Stem Cell Transplantation/methods , T-Lymphocyte Subsets/immunology , Bone Marrow Purging , Female , Hematopoietic Stem Cell Transplantation , Humans , Young Adult
17.
Acta Neurol Scand ; 124(2): 104-8, 2011 Aug.
Article in English | MEDLINE | ID: mdl-20849398

ABSTRACT

OBJECTIVE: To clarify the clinical manifestations of adult-onset Alexander disease (AOAD) in Japanese patients with glial fibrillary acidic protein (GFAP) gene mutations. METHODS AND MATERIALS: Twelve patients of AOAD with GFAP mutations detected in our centre were examined for neurological and magnetic resonance imaging (MRI) findings. RESULTS: Major symptoms were pyramidal and bulbar signs. In addition, three patients presented abnormal behaviour and/or memory disturbance. Two of the three patients also had Parkinsonism and had been diagnosed with fronto-temporal dementia or progressive supranuclear palsy until GFAP mutations were detected. Abnormalities of the medulla oblongata and cervical spinal cord were observed on MRI in all patients. CONCLUSIONS: Patients presenting with pyramidal and/or bulbar signs with abnormalities of the medulla oblongata and cervical spinal cord on MRI should be considered for GFAP analysis as this is the typical presentation of AOAD. Abnormal behaviour and cognitive disorders including deterioration of memory were rare symptoms but could be an obstacle to diagnosing Alexander disease.


Subject(s)
Alexander Disease/genetics , Glial Fibrillary Acidic Protein/genetics , Mutation/genetics , Adult , Age of Onset , Aged , Alexander Disease/diagnosis , Brain Stem/pathology , DNA Mutational Analysis , Female , Humans , Japan , Magnetic Resonance Imaging/methods , Male , Middle Aged , Neurologic Examination/methods , Spinal Cord/pathology
19.
Neurology ; 75(6): 555-61, 2010 Aug 10.
Article in English | MEDLINE | ID: mdl-20697108

ABSTRACT

OBJECTIVE: To evaluate whether the pretreatment Alberta Stroke Programme Early CT Score (ASPECTS) assessed using diffusion-weighted imaging (DWI) predicts stroke outcomes at 3 months following IV recombinant tissue-type plasminogen activator (rt-PA) therapy. METHODS: Stroke patients treated with rt-PA (0.6 mg/kg alteplase) in 10 stroke centers in Japan were retrospectively studied. ASPECTS was assessed on DWI just prior to rt-PA injection. The primary outcome was a modified Rankin Scale (mRS) score of 0-2 at 3 months. Secondary outcomes included death at 3 months and symptomatic intracerebral hemorrhage (sICH) within 36 hours. RESULTS: For the 477 patients (316 men, 71 +/- 11 years old) enrolled, the median NIH Stroke Scale score was 13 (interquartile range 7-18.5), the median ASPECTS on DWI was 8 (7-10), and sICH was identified in 15 patients (3.1%). At 3 months, 245 (51.4%) had an mRS score of 0-2, and 29 (6.1%) had died. Patients with an mRS score of 0-2 had higher median ASPECTS (9; interquartile range 8-10) than other patients (8; 6-9, p < 0.001). Using receiver operating characteristic curves, the optimal cutoff ASPECTS to predict an mRS score of 0-2 was > or =7. On multivariate regression analysis, ASPECTS > or =7 was related to an mRS score of 0-2 (odds ratio 1.85; 95% confidence interval 1.07-3.24), ASPECTS < or =4 was related to death (3.61; 1.23-9.91), and ASPECTS < or =5 was related to sICH (4.74; 1.54-13.64). CONCLUSION: ASPECTS on DWI was independently predictive of functional and vital outcomes at 3 months, as well as sICH within 36 hours, following rt-PA therapy for stroke patients.


Subject(s)
Fibrinolytic Agents/administration & dosage , Registries , Severity of Illness Index , Stroke/diagnosis , Stroke/drug therapy , Tissue Plasminogen Activator/administration & dosage , Aged , Aged, 80 and over , Female , Fibrinolytic Agents/therapeutic use , Humans , Japan/epidemiology , Male , Middle Aged , Predictive Value of Tests , Recombinant Proteins/administration & dosage , Recombinant Proteins/therapeutic use , Retrospective Studies , Stroke/epidemiology , Tissue Plasminogen Activator/therapeutic use , Treatment Outcome
20.
Hum Reprod ; 25(10): 2475-9, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20719814

ABSTRACT

BACKGROUND: The relationship between fibroids and infertility remains an unsolved question, and management of intramural fibroids is controversial. During the implantation phase, uterine peristalsis is dramatically reduced, which is thought to facilitate embryo implantation. Our aims were to evaluate (i) the occurrence and frequency of uterine peristalsis in infertile women with intramural fibroids and (ii) whether the presence of uterine peristalsis decreases the pregnancy rate. METHODS: Ninety-five infertile patients with uterine fibroids were examined using magnetic resonance imaging (MRI). Inclusion criteria were as follows: (i) presence of intramural fibroids, excluding submucosal type; (ii) no other significant infertility factors (excluding endometriosis); and (iii) regular menstrual cycles, and MRI performed at the time of implantation (luteal phase day 5-9). The frequency of junctional zone movement was evaluated using cine-mode-display MRI. After MRI, patients underwent infertility treatment for up to 4 months, and the pregnancy rate was evaluated prospectively. RESULTS: Fifty-one patients fulfilled the inclusion criteria, and 29 (57%) and 22 (43%) patients were assigned to the low (0 or 1 time/3 min) or high frequency (≥ 2 times/3 min) uterine peristalsis group, respectively. Endometriosis incidence was the same in both groups. Ten out of the 29 patients (34%) in the low-frequency group achieved pregnancy, compared with none of the 22 patients (0%) in the high-frequency group (P< 0.005). Comparing pregnant and non-pregnant cases, 4 of 10 patients (40%) and 9 of 41 patients (22%), respectively, had endometriosis (not significant). CONCLUSIONS: A higher frequency of uterine peristalsis during the mid-luteal phase might be one of the causes of infertility associated with intramural-type fibroids.


Subject(s)
Infertility, Female/etiology , Leiomyoma/physiopathology , Peristalsis , Pregnancy Complications, Neoplastic/physiopathology , Pregnancy Rate , Uterine Neoplasms/physiopathology , Adult , Clomiphene/therapeutic use , Endometriosis/diagnosis , Female , Fertility Agents, Female/therapeutic use , Humans , Infertility, Female/drug therapy , Leiomyoma/complications , Magnetic Resonance Imaging , Menotropins/therapeutic use , Ovulation Induction , Pregnancy , Prospective Studies , Retrospective Studies , Uterine Neoplasms/complications
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