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Matsui K, Kuroki A, Morishima A. Emedastine Inhibits Th1 and Th2 Cell Differentiation Mediated by Mast Cells. Biol Pharm Bull 2024; 47:527-531. [PMID: 38417904 DOI: 10.1248/bpb.b23-00765] [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] [Indexed: 03/01/2024]
Abstract
We have previously clarified that emedastine, a second-generation antihistamine drug, inhibits T helper 1(Th1)/Th2 cell differentiation mediated by Langerhans cells (LCs). In addition, although we have recently found that mast cells also function as antigen-presenting cells (APCs) and induce Th1/Th2 cell differentiation, any influence of emedastine on this function remained unclear. Here we investigated the influence of emedastine on Th1/Th2 cell differentiation via mast cells. Mast cells were obtained by long-term culture of murine splenocytes in medium supplemented with tumor necrosis factor (TNF)-α. The mast cells were then incubated in the presence or absence of emedastine, and cultured with naïve CD4+ T cells in the presence of ovalbumin (OVA) peptide. Five days later, Th cells in the culture were stimulated with phorbol 12-myristate 13-acetate (PMA) and ionomycin, and Th1/Th2 cytokine production was examined by enzyme-linked immunosorbent assay. When mast cells treated with emedastine were used as APCs, production of interferon (IFN)-γ and interleukin (IL)-4 from activated Th cells was significantly suppressed. This suppression was associated with inhibition of CD86 expression on mast cells, and mast cells treated with emedastine were shown to obstruct the differentiation of both Th1 and Th2 cells by down-regulating their cell surface expression of CD86. The present data provide additional information that topical application of emedastine to the lesional skin of patients with atopic dermatitis (AD) would reduce not only LC- but also mast cell-mediated skin inflammation.
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Affiliation(s)
- Katsuhiko Matsui
- Department of Clinical Immunology, Meiji Pharmaceutical University
| | - Akari Kuroki
- Department of Clinical Immunology, Meiji Pharmaceutical University
| | - Aya Morishima
- Department of Clinical Immunology, Meiji Pharmaceutical University
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Takeuchi T, Shinmura Y, Nakajima R, Hiramatsu K, Kubo T, Kimoto A, Kuroki A, Igarashi A, Tango T, Tanaka Y. FRI0280 Impact of Disease Duration before Starting Adalimumab Treatment on Work Productivity in Japanese Patients with Rheumatoid Arthritis; Analysis of 24-Weeks Data from the Anouveau Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Takeuchi T, Komatsu S, Muramatsu T, Kubo T, Kuroki A, Tango T, Tanaka Y. FRI0202 A large-scale prospective single cohort study of work productivity and activity impairment in japanese patients with rheumatoid arthritis receiving adalimumab: analysis of 24-weeks data from the anouveau study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1329] [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: 11/04/2022]
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Miyazaki N, Matsumoto J, Alberici F, Palmisano A, Maritati F, Oliva E, Buzio C, Vaglio A, Mjoen G, Norby GE, Vikse BE, Svarstad E, Rune B, Knut A, Szymczak M, Kuzniar J, Kopec W, Marchewka Z, Klinger M, Arrizabalaga P, Silvarino R, Sant F, Espinosa G, Sole M, Cervera R, Gude D, Chennamsetty S, Demin A, Kozlov V, Lisukov I, Kotova O, Sizikov A, Sergeevicheva V, Demina L, Borjesson O, Wendt M, Avik A, Qureshi AR, Bratt J, Miller EJ, Gunnarsson I, Bruchfeld A, Sugiyama K, Hasegawa M, Yamamoto K, Hayashi H, Koide S, Murakami K, Tomita M, Yoshida S, Yuzawa Y, Yew S, Jayne D, Westman K, Hoglund P, Flossman O, Mahr A, Luqmani R, Robson J, Thervet E, Levi C, Guiard E, Roland M, Nochy D, Daniliuc C, Guillevin L, Mouthon L, Jacquot C, Karras A, Kimura Y, Morita H, Debiec H, Yamada H, Miura N, Banno S, Ronco P, Imai H, Shin DH, Famee D, Koo HM, Han SH, Choi KH, Yoo TH, Kang SW, Fofi C, Fofi C, Scabbia L, Festuccia F, Stoppacciaro A, Mene' P, Shimizu A, Fukui M, MII A, Kaneko T, Masuda Y, Iino Y, Katayama Y, Fukuda Y, Kuroki A, Matsumoto K, Akizawa T, Jurubita R, Ismail G, Bobeica R, Rusu E, Zilisteanu D, Andronesi A, Motoi O, Ditoiu V, Copaci I, Voiculescu M, Irazabal MV, Eirin A, Lieske JC, Beck LH, Dillon JJ, Nachman PH, Sethi S, Erickson SB, Cattran DC, Fervenza FC, Svobodova B, Hruskova Z, Janatkova I, Jancova E, Tesar V, Seo MS, Kwon SH, Lee EB, You JY, Hyun YK, Woo SA, Park MY, Choi SJ, Jeon JS, Noh H, Kim JG, Han DC, Hwang SD, Choi TY, Jin SY, Kwon SH, Loiacono E, Loiacono E, Defedele D, Puccinelli MP, Camilla R, Gallo R, Peruzzi L, Rollino C, Beltrame G, Ferro M, Vergano L, Campolo F, Amore A, Coppo R, Knoop T, Vikse BE, Svarstad E, Bostad L, Leivestad T, Bjorneklett R, Teranishi J, Yamamoto R, Nagasawa Y, Shoji T, Iwatani H, Okada N, Moriyama T, Yamauchi A, Tsubakihara Y, Imai E, Rakugi H, Isaka Y, Koo HM, Doh FM, Kim SJ, Kang SW, Choi KH, Han DS, Han SH, Suzuki Y, Matsuzaki K, Suzuki H, Okazaki K, Yanagawa H, Maiguma M, Muto M, Sato T, Horikoshi S, Novak J, Hotta O, Tomino Y, Gutierrez* E, Zamora I, Ballarin J, Arce Y, Jimenez S, Quereda C, Olea T, Martinez-Ara J, Segarra A, Bernis C, Garcia A, Goicoechea M, Garcia de Vinuesa S, Rojas J, Praga M, Ristovska V, Petrushevska G, Grcevska L, Knoop T, Vikse BE, Svarstad E, Bostad L, Leivestad T, Bjorneklett R, Satake K, Shimizu Y, Mugitani N, Suzuki H, Suzuki Y, Horikoshi S, Honda S, Shibuya K, Shibuya A, Tomino Y, Papale M, Rocchetti MT, DI Paolo S, Suriano IV, D'apollo A, Vocino G, Montemurno E, Varraso L, Grandaliano G, Gesualdo L, Huerta A, Bomback AS, Canetta PA, Radhakrishnan J, Herlitz L, Stokes B, D'agati V, Markowitz G, Appel GB, Ristovska V, Grcevska L, Mouna H, Nasr BD, Mrabet I, Ahmed L, Sabra A, Mohamed Ammeur F, Mezri E, Habib S, Innocenti M, Pasquariello A, Pasquariello G, Mattei P, Bottai A, Fumagalli G, Bozzoli L, Samoni S, Cupisti A, Caldin B, Hung J, Repizo L, Malheiros DM, Barros R, Woronik V, Giammarresi C, Bono L, Ferrantelli A, Tortorici C, Licavoli G, Rotolo U, Huang X, Wang Q, Shi M, Chen W, Liu Z, Scarpioni R, Cantarini L, Lazzaro A, Ricardi M, Albertazzi V, Melfa L, Concesi C, Vallisa D, Cavanna L, Gungor G, Ataseven H, Demir A, Solak Y, Biyik M, Ozturk B, Polat I, Kiyici A, Ozer Cakir O, Polat H, Martinez-Ara J, Castillo I, Carreno V, Aguilar A, Madero R, Hernandez E, Bernis C, Bartolome J, Gea F, Selgas R, El Aggan HAM, El Banawy HS, Wagdy E, Tchebotareva N, LI O, Bobkova I, Kozlovskaya L, Varshavskiy V, Golicina E, Chen Y, Gong Z, Chen X, Tang L, Zhou J, Cao X, Wei R, Koo EH, Koo EH, Park JH, Kim HK, Kim MS, Jang HR, Lee JE, Huh W, Kim DJ, Oh HY, Kim YG, Tchebotareva N, Bobkova I, Kozlovskaya L, LI O, Eskova O, Shvetsov M, Golytsina E, Varshavskiy V, Popova O, Quaglia M, Monti S, Fenoglio R, Menegotto A, Airoldi A, Izzo C, Rizzo MA, Dianzani U, Stratta P, Vaglio A, Vaglio A, Alberici F, Gianfreda D, Buzio C. Primary and secondary glomerulonephritis I. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Tchebotareva N, Bobkova I, Kozlovskaya L, Li O, Plaisier E, Terrier B, Lacraz A, Bridoux F, Huart A, Marie I, Launay D, Hummel A, Saint-Martin L, Bonnet F, Belenotti P, Kahn JE, Hinschberger O, Rullier P, Cacoub P, Casian A, Szpirt W, Jayne D, Walsh M, Haris A, Polner K, Aranyi J, Braunitzer H, Meran Z, Kaszas I, Mazanowska O, Koscielska-Kasprzak K, Kaminska D, Penar J, Zabinska M, Dziemianko I, Krajewska M, Klinger M, Marco H, Corica M, Picazo M, Arce Y, Llobet JM, Diaz M, Ballarin J, Kuroki A, Akizawa T, Papasotiriou M, Kalliakmani P, Huang L, Gerolymos M, Goumenos DS, Johnson TS, Ogahara S, Abe Y, Ito K, Watanabe M, Saito T, Saito T, Watanabe M, Ito K, Abe Y, Ogahara S, Nesen A, Topchii I, Semenovylh P, Galchinskaya V, Bantis C, Heering P, Kouri NM, Schwandt C, Rump LC, Ivens K, Nagasawa Y, Iio K, Fukuda S, Date Y, Iwatani H, Yamamoto R, Horii A, Inohara H, Imai E, Ohno H, Rakugi H, Rakugi Y, Sahin OZ, Gibyeli Genek D, Alkan Tasli F, Yavas H, Gurses S, Yeniay P, Uzum A, Ersoy R, Cirit M, Christou D, Molyneux K, Peracha J, Feehally J, Smith AC, Barratt J, Yamamoto R, Nagasawa Y, Shoji T, Katakami N, Ohtoshi K, Hayaishi-Okano R, Yamasaki Y, Yamauchi A, Tsubakihara Y, Imai E, Rakugi H, Isaka Y, Faria B, Vidinha J, Pego C, Garrido J, Lemos S, Lima C, Sorbo G, Lorga E, Sousa T, Yavas HH, Sahin OZ, Ozen KP, Gibyeli Genek D, Ersoy R, Alkan Tasli F, Yucel O, Cirit M, Wada Y, Ogata H, Yamamoto M, Ito H, Kinugasa E, Lundberg S, Lundahl J, Gunnarsson I, Jacobson S, Camilla R, Loiacono E, Dapra V, Morando L, Conrieri M, Bianciotto M, Bosetti FM, Gallo R, Peruzzi L, Amore A, Coppo R, Jeong K, Kim Y, Lee TW, Lee SH, Moon JY, Lee S, Ihm C, Komatsu H, Fujimoto S, Kikuchi M, Sato Y, Kitamura K, Sulikowska B, Johnson R, Grajewska M, Donderski R, Odrowaz-Sypniewska G, Manitius J, Amore A, Camilla R, Morando L, Peruzzi L, Rollino C, Quarello F, Colla L, Segoloni G, Caramello E, Cravero R, Quaglia M, Stratta P, Mazzucco G, Coppo R, Coppo R, Grcevska L, Petrusevska G, Nikolov V, Polenakovic M, Lee KW, Ham YR, Jang WI, Jung JY, Jang DS, Chung S, Choi DE, Na KR, Shin YT, Sulikowska B, Johnson R, Grajewska M, Donderski R, Odrowaz-Sypniewska G, Manitius J, Pasquariello A, Innocenti M, Pasquariello G, Mattei P, Colombini E, Ricchiuti G, Sami N, Cupisti A, Rocchetti MT, Di Paolo S, Tamma G, Lasorsa D, Suriano IV, D'Apollo A, Papale M, Mastrofrancesco L, Grandaliano G, Svelto M, Valenti G, Gesualdo L, Wang C, Li Y, Jia N, Fan J, Vigotti FN, Daidola G, Colla L, Besso L, Segoloni GP, Rocchetti MT, Papale M, Di Paolo S, Vocino G, Suriano IV, D'Apollo A, Grandaliano G, Gesualdo L, Berthoux F, Mohey H, Laurent B, Mariat C, Afiani A, Thibaudin L, Rivera F, Segarra A, Praga M, Vozmediano C, Rivera F, Lopez JM, Hernandez D, Pesickova S, Rysava R, Lenicek M, Potlukova E, Jancova E, Vitek L, Honsova E, Zavada J, Svarcova J, Kalousova M, Trendelenburg M, Tesar V, Li X, Ren H, Zhang W, Pan X, Zhang Q, Chen X, Xu Y, Shen P, Chen N, Hruskova Z, Mareckova H, Svobodova B, Jancova E, Bednarova V, Rysava R, Tesar V, Bobrova L, Kozlovskaya N, Khafizova E, Meteleva N, Shakhnova E, Alsuwaida A, Hussain S, Alghonaim M, AlOudah N, Ullah A, Kfoury H, Lorusso P, Bottai A, Cipollini I, Giorgetti M, Barsotti G, Goplani K, Kaswan K, Gera D, Patel H, Gumber M, Shah P, Vanikar A, Trivedi H, Gluhovschi C, Gluhovschi G, Potencz E, Lazar E, Trandafirescu V, Petrica L, Velciov S, Bozdog G, Bob F, Gadalean F, Vernic C, Cioca D, Bantis C, Heering P, Stangou M, Kouri NM, Schwandt C, Memmos D, Rump LC, Ivens K, Tofik R, Rippe B, Torffvit O, Bakoush O, Silska M, Lipkowska K, Warzywoda A, Soltysiak J, Blumczynski A, Musielak A, Ostalska-Nowicka D, Zachwieja J, Spartalis M, Stangou M, Pliakos K, Oikonomidou D, Pantzaki A, Rizopoulou E, Efstratiadis G, Memmos D, Okino VT, Moyses Neto M, Silva GEB, Vieira Neto O, Romao EA, Coelho EB, Dantas M, Liakou H, Stangou M, Ekonomidou D, Pantzaki A, Patinakis P, Sigounas V, Efstratiadis G, Memmos D, Shvetsov M, Bobkova I, Zheng A, Li O, Chebotareva N, Kamyshova E, Rudenko T, Gelpi R, Navarro I, Ngango L, Poveda R, Goma M, Torras J, Grinyo JM, Fulladosa X, Wang Y, Ivany J, Jardine M, Zhong F, Wang W, Ren H, Xie Y, Huang Q, Chen N, Chiappini MG, Di Girolamo M, Grosso A, Muzi L, Panetta V, Khafizova E, Kozlovskaya N, Bobrova L, Bobkova I, Avdonin P, Gluhovschi C, Gluhovschi G, Potencz E, Lazar E, Trandafirescu V, Petrica L, Velciov S, Bozdog G, Bob F, Gadalean F, Vernic C, Cioca D, Ito M, Kimachi M, Nishio S, Koike T, Choi H, Cho AJ, Jang HR, Lee JE, Huh W, Kim DJ, Oh HY, Kim YG. Clinical Nephrology: primary and secondary glomerulonephritis. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.35] [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: 11/13/2022] Open
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Kuroki A, Ito J, Yokochi A, Kato N, Sugisaki T, Sueki H, Akizawa T. Diagnosing Alport syndrome using electron microscopy of the skin. Kidney Int 2008; 73:364-5. [PMID: 18195703 DOI: 10.1038/sj.ki.5002682] [Citation(s) in RCA: 7] [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: 11/09/2022]
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Kanno Y, Kuroki A, Okada K, Tomogane K, Ueshima S, Matsuo O, Matsuno H. Alpha2-antiplasmin is involved in the production of transforming growth factor beta1 and fibrosis. J Thromb Haemost 2007; 5:2266-73. [PMID: 17958745 DOI: 10.1111/j.1538-7836.2007.02745.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [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
BACKGROUND Fibrotic disease occurs in most tissues. Transforming growth factor (TGF)-beta is the major inducer of fibrosis. The fibrinolytic system is considered to play an important role in the degradation of extracellular matrices. However, the detailed mechanism of how this system affects fibrosis remains unclear. METHODS AND RESULTS We examined experimental fibrosis in mice with a deficiency of alpha(2)-antiplasmin (alpha2AP), which is a potent and specific plasmin inhibitor. We found that the lack of alpha2AP attenuated bleomycin-induced TGF-beta(1) synthesis and fibrosis. In addition, the production of TGF-beta(1) from the explanted fibroblasts of alpha2AP(-/-) mice decreased dramatically as compared to that in wild-type mice. Moreover, we found that alpha2AP specifically induces the production of TGF-beta(1) in fibroblasts. CONCLUSION The lack of alpha2AP attenuated TGF-beta(1) synthesis, thereby resulting in attenuated fibrosis. This is the first report to describe the crucial role that alpha2AP plays in TGF-beta(1) synthesis during the process of fibrosis. Our results provide new insights into the role of alpha2AP in fibrosis.
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Affiliation(s)
- Y Kanno
- Department of Clinical Pathological Biochemistry, Faculty of Pharmaceutical Science, D.W.C.L.A., Kyoto, Japan.
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Kuroki A, Toda T, Matsui K, Uotsu-Tomita R, Tomita M, Itaya M. Reshuffling of the Bacillus subtilis 168 Genome by Multifold Inversion. J Biochem 2007; 143:97-105. [DOI: 10.1093/jb/mvm197] [Citation(s) in RCA: 6] [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: 11/12/2022] Open
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Iyoda M, Ajiro Y, Sato K, Kuroki A, Shibata T, Kitazawa K, Sugisaki T. A case of refractory uremic pleuropericarditis--successful corticosteroid treatment. Clin Nephrol 2006; 65:290-3. [PMID: 16629230 DOI: 10.5414/cnp65290] [Citation(s) in RCA: 10] [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: 11/18/2022] Open
Abstract
We report the case of a patient with uremic pleuropericarditis who showed a marked improvement following corticosteroid therapy. A 66-year-old man who had been on hemodialysis therapy for 13 years was admitted to our hospital presenting with increases in bilateral pleural effusions and pericardial effusion. Repeated thoracentesis showed hemorrhagic and exudative findings. Pleural and pericardial fluid cytologic examination, bacterial culture and acid-fast staining showed negative findings. Despite the administration of antibiotics and antituberculosis drugs, low-grade fever continued and C-reactive protein level remained high. A pleural biopsy revealed fibrinous pleuritis without infectious disease or malignancy. He was diagnosed as having uremic pleuropericarditis on the basis of the clinicopathological features, but had been unresponsive to conventional treatments including repeated thoracentesis and the continuance of hemodiafiltration using nafamostat mesylate. Ultimately, both pleural and pericardial effusions were controlled after the treatment with prednisolone at an initial dose of 50 mg per day. In conclusion, corticosteroid therapy seems to be useful for treating patients with conventional therapy-resistant uremic pleuropericarditis.
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Affiliation(s)
- M Iyoda
- Department of Nephrology, Showa University School of Medicine, Tokyo, Japan.
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Iyoda M, Hato T, Matsumoto K, Ito J, Ajiro Y, Kuroki A, Shibata T, Kitazawa K, Sugisaki T. Rapidly progressive glomerulonephritis in a patient with Chlamydia pneumoniae infection: a possibility of superantigenic mechanism of its pathogenesis. Clin Nephrol 2006; 65:48-52. [PMID: 16429842 DOI: 10.5414/cnp65048] [Citation(s) in RCA: 8] [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: 11/18/2022] Open
Abstract
Herein we describe a case of a patient with rapidly progressive glomerulonephritis after Chlamydia pneumoniae infection. An 88-year-old woman who had had C. pneumoniae infection two months previously was admitted to our hospital with complaints of dyspnea and generalized edema. Laboratory tests revealed acute renal failure, polyclonal hypergammaglobulinemia, highly increased level of C-reactive protein, and hematoproteinuria. A renal biopsy revealed mesangial and endocapillary proliferative glomerulonephritis with crescents. She responded to high-dose steroids, cyclophosphamide, minocycline, and plasma exchange treatment with the remission of oliguric renal failure. The percentage of the subset of CD3+ TCR+ Vbeta11+ cells markedly increased to 9.6% (normal range: < 1.04%) at the onset of the disease and decreased to 0.1% after the treatment. These clinicopathological features were similar to those of superantigen-associated glomerulonephritis after methicillin-resistant Staphylococcus aureus infection. We suggest that the superantigenic mechanism is one of the possible pathomechanisms of this glomerulonephritis.
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Affiliation(s)
- M Iyoda
- Department of Nephrology, Showa University School of Medicine, Tokyo, Japan.
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Iyoda M, Matsumoto K, Hato T, Kuroki A, Shibata T, Kitazawa K, Sugisaki T. A case of elderly-onset systemic lupus erythematosus presenting as acute renal failure due to disseminated intravascular coagulation. Clin Nephrol 2005; 64:295-9. [PMID: 16240901 DOI: 10.5414/cnp64295] [Citation(s) in RCA: 1] [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: 11/18/2022] Open
Abstract
Herein we describe a case of a patient with elderly-onset systemic lupus erythematosus presenting as acute renal failure due to disseminated intravascular coagulation. A 78-year-old man was admitted to our hospital with fever and generalized lymphadenopathy. He was diagnosed as having systemic lupus erythematosus on the basis of renal involvement, hematological abnormality and positivity for antinuclear and anti-double-stranded DNA antibodies. Renal biopsy revealed lupus nephritis (class III and V (A/C)) with focal glomerular thrombosis. He responded to hemodialysis and corticosteroid therapy with remission of serological values and renal function. Possible mechanisms underlying the coexistence of these conditions are discussed.
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Affiliation(s)
- M Iyoda
- Department of Nephrology, Showa University, School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan.
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Abstract
The present status of endoscopic transsphenoidal surgery is introduced and reviewed. The difference between endoscopic and microscopic transsphenoidal surgery is explained and also the characteristics of the transnostril approach is mentioned. The advantages of endoscopic surgery are (1) good anatomical orientation with wider view, (2) tumors at the dead angle can be removed under the direct visualization, and (3) the patients can drink, eat and even brush their teeth just after surgery. Short hospital stay and even day-surgery could be possible when a patient is carefully selected. The disadvantages and the limitation of endoscopic surgery have been solved and improved with several new instruments and ideas. Moreover, we have made use of the surgical simulation with the three-dimensional (3-D) CT virtual navigation endoscopic image and the navigation system with the ENT application and the SureTrak of the Stealth Station. There is no need for head fixation with a Mayfield clamp or a C-arm intraoperative fluoroscopic image. This image guidance enabled a correct and smooth approach even in those patients with complicated and abnormal anatomical structures by prior surgery such as for sinusitis. The sellar floor can be safely and correctly opened even in patients with conchal type sphenoid sinus using a navigation system that helps to understand the locations of the cavernous sinus and the internal carotid arteries. The overall result by endoscopic transsphenoidal surgery is as good as or better than that by the traditional microscopic transsphenoidal surgery.
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Affiliation(s)
- A Kuroki
- Department of Neurosurgery, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan.
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Iyoda M, Kuroki A, Kato K, Kato N, Hirano T, Sugisaki T. A case of acute renal failure due to rhabdomyolysis, associated with non-autoimmune fulminant type 1B diabetes mellitus. Clin Nephrol 2003; 59:301-4. [PMID: 12708572 DOI: 10.5414/cnp59301] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A 38-year-old man developed severe diabetic ketoacidosis complicated with rhabdomyolysis and acute renal failure after presenting hyperglycemic symptoms for 4 days. Initial investigation showed significant hyperglycemia (blood glucose level 1,593 mg/dl) with a relatively low level of HbA1c (7.0%) and a high pancreatic enzyme concentration without any signs of pancreatitis. Diabetes-related antibodies were absent except for the anti-glutamic acid decarboxylase antibody, which disappeared later on. Pancreatic biopsy examination showed the lack of insulin-secreting cells, without insulitis. These findings were almost consistent with non-autoimmune fulminant type 1B diabetes. The patient remained dependent on dialysis for 1 month, then his renal function recovered. In patients with this type of diabetes, the onset of overt diabetes, frequently accompanied with severe diabetic ketoacidosis, is rapid, hence, early detection, quick diagnosis and immediate treatment of this novel type of diabetes are important in the rescue of these patients.
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Affiliation(s)
- M Iyoda
- Department of Nephrology, Showa University School of Medicine, Tokyo, Japan
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Mizuochi T, Pastore Y, Shikata K, Kuroki A, Kikuchi S, Fulpius T, Nakata M, Fossati-Jimack L, Reininger L, Matsushita M, Fujita T, Izui S. Role of galactosylation in the renal pathogenicity of murine immunoglobulin G3 monoclonal cryoglobulins. Blood 2001; 97:3537-43. [PMID: 11369648 DOI: 10.1182/blood.v97.11.3537] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [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: 11/20/2022] Open
Abstract
Cryoglobulin activity associated with murine immunoglobulin G3 (IgG3) has been shown to play a significant role in the development of murine lupuslike glomerulonephritis. A fraction, but not all, IgG3 monoclonal antibodies are capable of inducing a severe acute lupuslike glomerulonephritis as a result of direct localization of IgG3 cryoglobulins, suggesting the importance of qualitative features of cryoglobulins in their nephritogenic activities. Here a remarkable difference is shown in the renal pathogenicity of 2 murine IgG3 monoclonal cryoglobulins, identical in the amino acid sequences of their heavy and light chains but different in galactosylation patterns of oligosaccharide side chains because of their synthesis in different myeloma cells. The antibody lacking the capacity to induce severe glomerulonephritis displayed an increased proportion of galactosylated heavy chains. Changes in conformation, as revealed by gel filtration analysis, reduced cryoglobulin activity, and accelerated clearance could account for the lack of the renal pathogenicity of the more galactosylated variant. This observation provides a direct demonstration for the role of IgG galactosylation in the pathogenic potential of cryoglobulins.
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Affiliation(s)
- T Mizuochi
- Department of Applied Biochemistry, Tokai University, Hiratsuka, Kanagawa, Japan
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15
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Pastore Y, Lajaunias F, Kuroki A, Moll T, Kikuchi S, Izui S. An experimental model of cryoglobulin-associated vasculitis in mice. Springer Semin Immunopathol 2001; 23:315-29. [PMID: 11591105 DOI: 10.1007/s002810100075] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Y Pastore
- Department of Pathology, University of Geneva, 1211 Geneva 4, Switzerland
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16
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Kato N, Kayama T, Sakurada K, Saino M, Kuroki A. [Radiation induced glioblastoma: a case report]. No To Shinkei 2000; 52:413-8. [PMID: 10845210] [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: 04/14/2023]
Abstract
We report a surgical case of a 54-year-old woman with a radiation induced glioblastoma. At the age of 34, the patient was diagnosed to have a non-functioning pituitary adenoma. It was partially removed followed by 50 Gy focal irradiation with a 5 x 5 cm lateral opposed field. Twenty years later, she suffered from rapidly increasing symptoms such as aphasia and right hemiparesis. MRI showed a large mass lesion in the left temporal lobe as well as small mass lesions in the brain stem and the right medial temporal lobe. These lesions situated within the irradiated field. Magnetic resonance spectroscopy revealed relatively high lactate signal and decreased N-acetyl aspartate, choline, creatine and phosphocreatine signals. Increased lactate signal meant anaerobic metabolism that suggested the existence of a rapidly growing malignant tumor. Thus, we planned surgical removal of the left temporal lesion with the diagnosis of a radiation induced malignant glioma. The histological examination revealed a glioblastoma with radiation necrosis. MIB-1 staining index was 65%. Postoperatively, her symptoms improved, but she died from pneumonia 1 month after the surgery. An autopsy was obtained. The lesion of the left temporal lobe was found to have continuity to the lesion in the midbrain, the pons and the right temporal lobe as well. High MIB-1 staining index suggested that a radiation induced glioblastoma had high proliferative potential comparing with a de novo and a secondary glioblastoma.
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Affiliation(s)
- N Kato
- Department of Neurosurgery, Yamagata University School of Medicine, Japan
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17
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Affiliation(s)
- K Sakurada
- Department of Neurosurgery, Yamagata University School of Medicine, Yamagata, Japan
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18
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Takemura S, Sato S, Kuroki A, Saito S, Kayama T. [New ideas for indirect revascularization surgery for moyamoya disease]. No Shinkei Geka 1999; 27:987-92. [PMID: 10565041] [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: 02/14/2023]
Abstract
We had performed indirect revascularization surgery, mainly EMS, for cases with moyamoya disease, because EMS can revascularize a large area including the territory of anterior cerebral artery. However, in our initial cases, we found that three sides in two cases had post-operative ischemic complications. These cases suggested that intracranial hypertension due to pressure exerted by swelling caused by edema in the myoflap after EMS was one of the reasons for these infarctions. For the prevention of intracranial hypertension due to the edema in the myoflap, when we did EDAMS with dural pedicle insertion, we put into practice the new ideas about shaving the boneflaps to half of their original thickness, and prescribed 20% Mannitol after surgery. We tried these new ideas concerning treatment on four sides in three cases with moyamoya disease, and we were able to get good outcomes without any new neurological deficits.
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Affiliation(s)
- S Takemura
- Department of Neurosurgery, Yamagata University School of Medicine, Japan
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19
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Kuroki A, Kayama T, Song J, Saito S. Removal of petrous apex meningioma and microvascular decompression for trigeminal neuralgia through the anterior petrosal approach. Case report. Neurol Med Chir (Tokyo) 1999; 39:447-51. [PMID: 10396120 DOI: 10.2176/nmc.39.447] [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: 11/20/2022] Open
Abstract
A 64-year-old female presented with right trigeminal neuralgia. Computed tomography and magnetic resonance (MR) imaging demonstrated a tumor attached to the right petrous apex. MR imaging also revealed that the trigeminal nerve was compressed and distorted by the tumor. Tumor removal and microvascular decompression (MVD) were performed via the anterior petrosal approach. The trigeminal nerve was distorted by the tumor and the superior cerebellar artery compressed the medial part of the root entry zone of the trigeminal nerve. The surgery resulted in complete relief of the trigeminal neuralgia. Posterior fossa tumors causing ipsilateral trigeminal neuralgia are not rare, and are often removed via the suboccipital retromastoid approach, as MVD for trigeminal neuralgia is usually performed through the retromastoid approach. The advantages of the anterior petrosal approach are shorter access to the lesion and direct exposure without interference from the cranial nerves, and that bleeding from the tumors is easily controlled as the feeding arteries can be managed in the early stage of the surgery. We conclude that the anterior petrosal approach is safe and advantageous for the removal of petrous apex tumor associated with trigeminal neuralgia.
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Affiliation(s)
- A Kuroki
- Department of Neurosurgery, Yamagata University School of Medicine
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20
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Affiliation(s)
- K Kuroki
- Kuroki Gastrointestinal Surgical Hospital, Kagoshima, Japan
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21
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Kokubo Y, Kayama T, Saito S, Kuroki A, Saino M, Nakajima M. [A case of tuberous sclerosis presenting intractable adversive seizure, successfully resected with the technique of "gyrectomy"]. No Shinkei Geka 1997; 25:959-64. [PMID: 9330402] [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 a 9-year-old girl with tuberous sclerosis presenting intractable adversive seizure. She had been suffering from frequent attacks of consciousness loss since the age of 6 years. Although a considerable amount of antiepileptic drugs had been administered, her epileptic attacks were not controlled, but instead rather increased. She had been suffering from adversive seizure to the right for more than 2 years. CT scan failed to show any abnormal density area. MRI showed a small lesion in the left frontal subcortical area. The electroencephalogram showed relatively mild abnormal waves in the left hemisphere. We undertook surgical removal of the lesion with epileptogenic foci because her epilepsy has not been controlled and the lesion could be a glioma. Abnormal spike waves were detected around the lesion with electrocorticogram. "Gyrectomy" technique was employed and the spike waves totally disappeared. After the surgery, no neurological deterioration was presented. She has suffered no seizure attack since the surgery even though the amount of the antiepileptic drugs has been significantly decreased. Resection of the epileptogenic foci as well as the abnormal lesion using the technique of gyrectomy is useful for the control of the intractable epilepsy, and makes the quality of life of patients much higher.
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Affiliation(s)
- Y Kokubo
- Department of Neurosurgery, Yamagata University School of Medicine
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22
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Ando T, Kayama T, Saito S, Kuroki A, Nakai O, Itagaki S. [The EMG findings of spasmodic torticollis--the character of the EMG findings of neurogenic torticollis]. No To Shinkei 1997; 49:619-26. [PMID: 9234249] [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: 02/04/2023]
Abstract
Spasmodic torticollis is a clinical entity that is hard to treat though various symptomatic therapy have been tried. On the other hand, microvascular decompression operation have been established for cranial nerve vascular compression syndrome such as hemifacial spasm. Case reports on the decompression of the spinal accessory nerve for the treatment of spasmodic torticollis have been published on the basis of the concept of cranial nerve vascular compression syndrome. Thus, spasmodic torticollis related to unilateral accessory nerve has attracted much attention for selecting an optimal treatment, although there have not been any diagnostic criteria with electromyographic study. From the viewpoint of the clinical electrophysiological findings on hemifacial spasm those we have acquired by EMG study, we have examined the EMG findings of various types of spasmodic torticollis and here report the classification of spasmodic torticollis based on the EMG study. Thirty-five patients with spasmodic torticollis were analyzed. The symptoms were classified to the horizontal rotation type, the lateral bending type and the mixed type with the number of each group of 23, 2 and 10, respectively. As we have shown the criteria of the EMG findings on hemifacial spasm, the EMG of the patients with spasmodic torticollis were analyzed on four conditions as follows; (1) distribution of the involved muscles, (2) maximum firing rate of the abnormal spontaneous activity of the sternocleidomastoid muscle, (3) synkinetic discharge between the muscles innervated by unilateral accessory nerve and (4) alteration of the spontaneous muscle discharge by posture change. Abnormal spontaneous muscle discharges were recorded only from the sternocleidomastoid muscle and the trapezius muscle on the same side in twelve patients. Maximum firing rate of spontaneous muscle discharge was higher than that of maximum voluntary contraction in twenty-two patients. Abnormal synkinetic discharge was recorded between the sternocleidomastoid muscle and the trapezius muscle on the same side in twenty-one patients. Spontaneous EMG activities of the muscles innervated by the accessory nerve increased when the patients stood up from the resting supine position in thirty-one patients. Thus, ten patients out of thirty-five subjects had all four conditions mentioned above as typical patients with hemifacial spasm usually had. These ten patients with spasmodic torticollis were thought to have strong similarity to the EMG characteristics of hemifacial spasm that suggested hyperexcitability of unilateral accessory nervous system. This classification with EMG is considered to be useful in diagnosing the spasmodic torticollis related to unilateral accessory nerve and can be applied for selecting an optimal treatment.
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Affiliation(s)
- T Ando
- Department of Neurosurgery, Yamagata University School of Medicine, Japan
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23
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Saino M, Kayama T, Kuroki A, Siraisi Y, Sato K, Nakai O. [An operative case of cholesterol granuloma of the petrous apex]. No Shinkei Geka 1996; 24:1041-4. [PMID: 8934474] [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: 02/03/2023]
Abstract
A 59-year-old man presented with a rare cholesterol granuloma of the petrous apex manifesting as headache, left facial dysesthesia, diplopia, left hearing impairment, and left tinnitus. Neurological examination revealed dysesthesia of territory in all divisions of the left trigeminal nerve, left incomplete abducens nerve palsy, left mixed hearing impairment, and left tinnitus. Plain CT scan showed a smoothly marginated mass involving the left petrous apex. The mass was isodense with the brain parenchyma and not enhanced by contrast medium. The mass appeared heterogeneously slightly hyperintense on the T1-weighted MR image and homogeneously hyperintense on the T2-weighted MR image except for the peripheral portion. The mass was not enhanced after intravenous gadolinium DTPA administration. Surgery via a petrosal approach totally removed the mass in the intracranial, extradural space. Histological examination showed typical features of cholesterol granuloma, with cholesterin clefts, hemosiderin deposits, and erythrocytes in non-specific granulation tissue. Cholesterol granuloma most commonly occurs in the middle ear cavity, and rarely in the petrous apex. The characteristic hyperintense appearance of cholesterol granuloma on T1- and T2-weighted MR images is very useful for differentiation from other lesions of the petrous apex and the cerebellopontine angle such as cholesteatoma, mucocele, chordoma, and meningioma. Solid cholesterol granuloma of the petrous apex should be treated by total removal via craniotomy, not by drainage which is commonly performed by otorhinologists.
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Affiliation(s)
- M Saino
- Department of Surgical Neurology, Yamagata University School of Medicine
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24
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Kuroki A, Møller AR. Microsurgical anatomy around the foramen of Luschka in relation to intraoperative recording of auditory evoked potentials from the cochlear nuclei. J Neurosurg 1995; 82:933-9. [PMID: 7760194 DOI: 10.3171/jns.1995.82.6.0933] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [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: 01/27/2023]
Abstract
Three cadaveric heads were dissected to investigate the microsurgical anatomy around the foramen of Luschka. It was found possible to place a recording electrode in proximity to the cochlear nuclei by inserting it in the lateral recess of the fourth ventricle through the foramen of Luschka. In operations of the cerebellopontine angle using the retromastoid approach, access to the foramen of Luschka and the lateral recess is obtained by retracting the biventral lobule of the cerebellum in a caudal-rostral direction under a caudal-rostral/medial field of vision. The craniectomy might need to be enlarged a few millimeters in the caudal direction. A wick electrode can be inserted in the lateral recess beneath the choroid plexus in a rostromedial direction and to a depth of approximately 3 to 5 mm from the foramen of Luschka without excessive retraction of the cerebellum. The optimum position for the recording electrode is in the triangle formed by the axis of the cochlear nerve and the glossopharyngeal nerve and by the lip of the foramen of Luschka. The caudal retromastoid approach is more suitable than the translabyrinthine technique for recording from the cochlear nuclei as well as for implantation of stimulating electrodes into the cochlear nuclei for use as hearing prostheses.
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Affiliation(s)
- A Kuroki
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pennsylvania, USA
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25
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Kuroki A, Honda H, Kobayashi K, Totsuka D, Sugisaki T, Soejima K. A case of autosomal dominant polycystic kidney disease complicated by minimal change nephrotic syndrome. Clin Nephrol 1995; 43:131-2. [PMID: 7736675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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26
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Abstract
We recorded evoked potentials from the facial motonucleus of rats in response to electrical stimulation of the temporal branch of the facial nerve in which chronic irritation from a blood vessel had caused the development of an abnormal muscle response. The abnormal muscle response that can be recorded from face muscles that are innervated by one branch of the facial nerve in response to electrical stimulation of a different branch is regarded to be a sign of hemifacial spasm. In the recordings from the motonucleus in rats that showed such an abnormal muscle response (model rats) there was a late component at a latency of about 5 msec, in addition to the early component with a latency of 1.5-2.5 msec that is also observed in normal rats. The latency of the electromyographic potentials recorded from the mentalis-orbicularis oris muscles in response to stimulation of the facial motonucleus was about 2 msec. The latency of the abnormal muscle response obtained from the mentalis muscle in the model rats was about 7 msec. This value is close to the sum of the conduction time from the motonucleus to the mentalis muscle (2 msec) and the latency of the late response from the motonucleus (5 msec). Similar results were obtained in rats in which the facial nerve had been chronically stimulated electrically and which had developed an abnormal muscle response. The results of this study further support the hypothesis that the hyperactivity of the facial motonucleus is the pathophysiology of hemifacial spasm.
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Affiliation(s)
- A Kuroki
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, PA 15213
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27
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Abstract
The abnormal muscle response, elicited by electrical stimulation of one branch of the facial nerve and recorded from muscles innervated by another branch, has been used previously as an objective sign of hemifacial spasm in the development of animal models of this disorder. In the present study we recorded spontaneous electromyographic activity from the orbicularis oculi muscle from both sides in rats in which a demyelination of the peripheral portion of the facial nerve and vascular contact had been made previously. The root mean square value of the electromyographic activity on the affected side was significantly larger than that on the unaffected side in all rats in which the vascular irritation had caused the abnormal muscle response to appear. The results support our earlier finding that vascular contact together with demyelination of the peripheral facial nerve can cause the development of signs of hemifacial spasm, including involuntary muscle contractions.
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Affiliation(s)
- A Kuroki
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, PA 15213
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28
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Kuroki A, Møller AR. Facial nerve demyelination and vascular compression are both needed to induce facial hyperactivity: a study in rats. Acta Neurochir (Wien) 1994; 126:149-57. [PMID: 8042548 DOI: 10.1007/bf01476426] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.0] [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
It is generally assumed that hemifacial spasm (HFS) is caused by vascular compression of the facial nerve at the root exit zone (REZ), but the mechanism for the development of HFS is not known. Evidence has been previously presented that the signs of HFS are caused by hyperactivity of the facial motonucleus that is caused by the irritation to the facial nerve from the vascular contact. This assumption has been supported by the finding that daily electrical stimulation of the facial nerve in the rat facilitates the development of an abnormal muscle response that is a characteristic sign of HFS in man and is an indication of an abnormal cross-transmission that makes it possible to elicit a contraction of muscles innervated by one branch of the facial nerve by electrically stimulating another branch of the facial nerve. In the present study we show that close contact between a peripheral branch of the facial nerve and an artery also facilitates the development of an abnormal muscle response, but only if the facial nerve has previously been slightly injured (by a chromic suture) at the location of the arterial contact. We also show that blocking neural conduction in the facial nerve proximal to the artificial vascular compression abolishes the abnormal muscle contraction, which supports the assumption that the anatomical location of cross-transmission that is causing the abnormal muscle response is central to the vascular compression, most likely in the facial motonucleus. These findings may explain why the facial nerve is only susceptible to vascular compression near its REZ, where an injury to its myelin is more likely to occur than where the nerve is covered with schwann cell myelin.
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Affiliation(s)
- A Kuroki
- Department of Surgical Neurology, Yamagata University School of Medicine, Japan
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Abstract
A neurological disorder was noted in 5 cows on a farm. Histopathological examination in 2 of these 5 animals revealed an infiltration of eosinophils with some macrophages in the meninges and around arterioles of the cerebral cortex. The endothelial cells of the reactive blood vessels were swollen. From these observations, the brain lesions were diagnosed as "eosinophilic meningitis". In one case, pulmonary arterioles were also infiltrated with eosinophils and macrophages in a granulomatous tissue. No bacteria, fungi, protozoa, or parasitic worms were detected in the present cases.
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Affiliation(s)
- K Uchida
- Department of Veterinary Pathology, Faculty of Agriculture, Miyazaki University, Japan
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30
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Kuroki A, Itagaki S, Saito S, Nakai O. [Correlation between the analgesic effect by thalamic relay nucleus stimulation and somatosensory evoked potentials recorded from thalamus]. No To Shinkei 1992; 44:435-41. [PMID: 1520564] [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
Electric stimulation of the thalamic sensory relay nucleus (Vc) has an analgesic effect on deafferentation pain, however, the analgesic effect differs from patient to patient. Electrode position and state of the substrate stimulated are considered important factors influencing the analgesic effect. In order to determine the best position for the stimulating electrodes, we recorded somatosensory evoked potentials (SEPs) from stimulating electrodes implanted in the Vc and compared thalamic SEPs with the analgesic effect of Vc stimulation. The subjects were thirteen patients with deafferentation pain, four patients with thalamic lesions, seven patients with suprathalamic lesions and two patients with infrathalamic lesions. We inserted the electrode array into the Vc stereotactically, and fixed it so that stimulation-induced paresthesia would cover the painful frea. The electrode array consisted of the four contact points of four electrodes spaced at 2 mm intervals within 10 mm from the tip. Using bipolar combinations of the four electrodes (twelve combinations in all), we stimulated the Vc for about half an hour with each combination. We then rated the degree (%) of analgesia as 100% when pain disappeared and 0% when there was no change. Thalamic SEPs elicited after stimulation of the contralateral median nerve were recorded from all four contact points simultaneously. The latencies, amplitudes and recorded positions of large early positive components (P1) followed by large negative components (N1) with latencies between 10 and 20 msec were then analyzed and compared with the best electrode combination for optimal pain relief and with the degree of analgesia.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Kuroki
- Department of Surgical Neurology, Yamagata University School of Medicine, Japan
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31
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Kuroki A, Egami K, Wakayama S, Araki Y, Fuwa N. [Nutritional care and nursing during intratracheal intubation--on tube feeding]. Kango Gijutsu 1985; 31:2165-9. [PMID: 3937924] [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: 01/08/2023]
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32
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Takada M, Namikawa T, Kuroki A, Ishibuchi N, Iwabuchi T. [Clinical training systems at hospitals. Continuing workshops for clinical instructors for the improvement of clinical nursing training]. Kango Tenbo 1983; 8:214-21. [PMID: 6554398] [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: 04/05/2023]
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