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Biomedical subjects

A Hidaka

Publications and source records attributed to A Hidaka.

At least 55 records · Page 3Linked to original sources
PubMed1991

Cystic papillary carcinoma of the thyroid gland: a new sonographic sign.

Cystic thyroid lesions are generally considered to be benign and managed by repeated aspiration and/or biopsy. We report characteristic sonographic signs in eight cases of cystic papillary carcinomas of the thyroid gland. In all eight cases, ultrasonography (US) revealed mostly cystic lesions with solid excrescences protruding into the cyst. These nodules contained multiple punctate echogenic foci suggesting calcification. In three of these cases the initial fine needle aspiration biopsy was negative. The 'calcified nodule in cyst' sign was found to be very specific for cystic thyroid carcinoma in a review of the ultrasound findings in 115 patients with nodular thyroid lesions. Careful evaluation and/or surgery should be recommended in patients who have such characteristic sonographic findings even if the fine needle aspiration result is negative.

Adult↗
PubMed1991

Induction of c-fos and c-myc mRNA expression by immunoglobulin G from patients with Graves' disease in thyrotrophin-dependent rat thyroid cell line (FRTL5).

The present study was conducted to evaluate effects of autoantibodies in patients with Graves' disease on induction of c-fos and c-myc mRNA expression in rat thyroid cell line (FRTL5). IgG fractions were isolated from 11 patients with Graves' disease, and six healthy subjects, with protein A-Sepharose. FRTL5 cells which had been grown to subconfluency and deprived of TSH for a week were exposed to the IgG for an hour. Expression of c-fos and c-myc mRNAs was examined by the Northern blot method using nick-translated v-fos and c-myc probes. C-fos and c-myc transcripts were induced by IgGs from two patients with Graves' disease, which displayed much higher activities in assays for TSH binding inhibitor immunoglobulins, thyroid stimulating antibodies and thyroid growth-stimulating immunoglobulins, assessed by measuring inhibition of 125I-TSH binding to the TSH-receptor, cAMP production and 3H-thymidine incorporation in FRTL5 cells, respectively, compared with those in the remaining patients. The induction of c-fos and c-myc mRNAs by IgG from a patient with Graves' disease was suppressed by preincubation with IgGs from two patients with primary myxoedema who were known to have a blocking type TSH-receptor antibody. These data suggest that the binding of the antibodies to the TSH-receptor followed by cAMP production is related to the induction of c-fos and c-myc mRNAs and, thus, to the growth of FRTL5 cells. To our knowledge, this is the first report demonstrating that autoantibodies induce proto-oncogene mRNA expression.

Adolescent↗
PubMed1991

Lymphoproliferative disorders of the thyroid gland: radiological appearances.

Images of lymphoproliferative disorders of the thyroid by ultrasonography (US), computed tomography (CT), 99Tcm and 67Ga scintigraphy were analysed in eight patients (two men and six women, aged 42-83 years). Seven patients were diagnosed as having primary lymphoma and one plasmacytoma. Ultrasound revealed a solid mass with homogeneous and very low echogenicity clearly distinguishable from residual thyroid tissue in five patients, diffuse hypoechoic goitre in one and multiple irregular hypoechoic nodules in both lobes in the patient with plasmacytoma (Case 8). Computed tomography demonstrated a focal low-density area in six cases of lymphoma and decreased density throughout the gland in the other two patients. 99Tcm scintigraphy showed hemilobar enlargement with decreased and uneven trapping, cold area or complete lobar defect in six patients with lymphoma and no trapping in the case of plasmacytoma. 67Ga scintigraphy demonstrated high accumulation in lymphoma and faint accumulation in the case of plasmacytoma. Radiological manifestations with a focal lesion were considered typical and diagnostic of primary thyroid lymphoma, while in one case with diffuse infiltration through the whole gland, the differential diagnosis from Hashimoto's thyroiditis could not be made. In the final case, cells infiltrated diffusely to form islands with patchy distribution among well preserved follicles, correlating with the multiple hypoechoic areas observed by US.

Adult↗
PubMed1991

[Prediction of remission in Graves' disease after thionamide therapy by technetium-99m early uptake].

In the clinical management of Graves' thyrotoxicosis, one of the most important subject is when to stop antithyroid drugs after achieving an euthyroid state. T3 suppression test and other methods have been used to forecast the outcome after drug cessation, but the results were not always satisfactory. We have attempted to predict remission of Graves' disease by single measurement of early technetium uptake without administration of triiodothyronine. Drugs were discontinued in the seventy-five patients with Graves' disease on maintenance doses of either methimazole or propylthiouracil who showed normalized uptake (4.0% or less). Of 64 patients evaluable after twelve months, 55 (86%) remained euthyroid, 8 relapsed, and 1 became hypothyroid. With its accuracy in prediction of short-term remission comparable or superior to T3 suppression test, this rapid and simple method seemed suitable for routine use in clinical practice.

Adult↗
PubMed1991

[Clinical backgrounds in two kinds (absolute and relative) of mild pregnancy induced hypertension].

The criteria for pregnancy induced hypertension (PIH) have been determined by the Japanese Obstetrics and Gynecology Society. Mild PIH is classified into two types. One is "Absolute-PIH (A-PIH)" diagnosed by 1) systolic blood pressure (SBP) greater than = 140mmHg and less than 160mmHg or 2) diastolic blood pressure (DBP) greater than = 90mmHg and less than 110mmg. Another one is "Relative-PIH (R-PIH)" diagnosed by 3) an increase in SBP greater than = 30mmHg compared to normal SBP or 4) an increase in DBP greater than = 15mmHg compared to normal DBP. However, there has been no report in which two types of PIH are assessed. Our hypothesis is that the pathophysiology of two types of PIH is different. The purpose of this study is to clarify the pathophysiological difference by evaluating the clinical backgrounds. We evaluated 963 nullipara and 747 multipara whose pregnancies were recorded from the 1st trimester (multiple pregnancy and pre-term delivery before 32 gestational weeks were excluded). Among 765 nullipara women, 79.4% were diagnosed as having normal blood pressure (N-group), 7.1% as A-PIH, and 13.0% as R-PIH. In the multipara N-group, the figures were 632 women (84.6%), A-PIH, 4.6% and R-PIH, 10.3%. Clinical backgrounds showed that the incidence of hypertensive family history, high hematocrit (greater than = 39.0) before the 12th gestational week or obesity (Kaup index greater than = 24 before pregnancy) was significantly higher in A-PIH than in the N-group of nullipara and higher in the A-PIH than in the R-PIH and N-groups of multipara.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Effects of maternal postural change from supine to left-lateral on tocolysis, maternal cardiac function and pulsatility index of uterine artery.

In order to prove the usefulness of the left-lateral position (l-lat.) in preventing the cardiovascular complications associated with ritodrine, twenty-nine patients having preterm labor were employed as the subjects of this study. Before and during the administration of ritodrine, the cardiac function was recorded by impedance cardiography. (1) When ritodrine was administered in the supine position, SV and CO first increased but eventually tended to decrease. When the position was changed to the l-lat. after SV and CO had almost returned to the preadministration level, HR decreased and SV and CO increased in 70% (10/14) of the patients. However, in patients showing no change in HR in the supine position, the cardiac function did not change either. (2) The magnitude of the changes in cardiac function accompanying the postural change during ritodrine administration was compared with that observed before administration. The decrease in HR and the increase in SV due to the postural change to the l-lat. were larger during ritodrine administration than before administration. The l-lat. position is recommended as a means for preventing the side effects accompanying ritodrine administration. This study also indicated the possibility that the inferior vena cava may be more strongly compressed in the supine position by the relaxed gravid uterus.

Cardiac Output↗
PubMed1991

Effect of left-lateral position on maternal hemodynamics during ritodrine treatment in comparison with supine position.

Pregnant women are generally recommended to rest in the left-lateral position (l-lat.) to avoid caval compression. We studied the influence of postural change from the supine position (sup.) to the l-lat. on maternal hemodynamics and tocolysis. The cardiac output (CO) was measured by impedance cardiography, while the pulsatility index of the uterine artery (PIUtA) was determined by the pulsed Doppler method. When the maternal posture was changed from sup. to l-lat, the following results were obtained. (1) The frequency of uterine contractions (UC) (preterm labor = 92) was significantly reduced (p less than 0.01). (2) The resting uterine tonus (n = 5) was also significantly decreased (p less than 0.05). (3) In the cases showing a decrease in the frequency of UC, the CO value was significantly increased (p less than 0.01), whereas PIUtA was significantly decreased (p less than 0.01). It is concluded that the postural change from sup. to l-lat. resulted in a decrease in the frequency of UC and the resting uterine tonus and at the same time an increase in the CO and decrease in the vascular resistance of the uterine artery.

Cardiac Output↗
PubMed1991

[Effect of maternal postural change on maternal hemodynamics in late pregnancy--supine hypertension].

The purpose of this investigation was to ascertain the effect of postural change in late pregnant women from the left lateral recumbent position to the supine position on their blood circulation. Patients in whom the blood pressure at the right upper limb in the supine position increased by at least 20mmHg or more (diastolic and/or systolic pressure) were classified as the supine hypertensive group. Patients in whom the blood pressure of the right upper limb decreased by at least 20mmHg or more were classified as the supine hypotensive group. And other patients were classified as the no blood pressure change group. The results were as follows. 1. The incidence of supine hypertension was 48% in primigravidas and 38% in multigravidas. Supine hypertension was especially common in PIH (pregnancy induced hypertension) complicated women (75%). 2. Maternal cardiac function: With postural change from the left lateral recumbent position to the supine position, CO (cardiac output) decreased and SVR (systemic vascular resistance) was increased in both the supine hypertensive and the no blood pressure change groups by the thermodilution method (n = 14). CVP (central venous pressure) and PCWP (pulmonary capillary wedge pressure) shows different pattern of change in the supine hypertensive group and the no blood pressure change group. In the former group, CVP was decreased by 45 +/- 16% and PCWP was increased by 21 +/- 9% in the supine position compared with in the left lateral recumbent position. However, in the latter group, CVP decreased by 87 +/- 69% and PCWP decreased by 53 +/- 46% as the result of the same postural change.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Output↗
PubMed1991

Follow-up study of postoperative patients with thyroid cancer by thallium-201 scintigraphy and serum thyroglobulin measurement.

The utility of 201TI scintigraphy and thyroglobulin measurement in the follow-up observation of postoperative patients with thyroid cancer was evaluated. Thallium-201 scintigraphy was performed in 149 postoperative patients with thyroid cancer. Serum thyroglobulin concentration was concomitantly evaluated in 86 patients. Among 55 patients with positive 201TI scans, 51 patients (92.7%) had recurrent diseases, while 80 of 94 patients (85.1%) with negative scans were free of disease. Twenty-five of 28 patients (89.3%) with elevated thyroglobulin levels were recurrent and 43 of 58 patients (74.1%) with normal thyroglobulin level had no recurrence nor metastasis. All 19 patients with positive 201TI scans and elevated thyroglobulin level had recurrent lesions. Seven of 10 patients with negative 201TI scans and elevated thyroglobulin level showed the presence of metastasis. By concomitant measurement of serum thyroglobulin, more than half of the recurrent patients with negative 201TI scintigraphy were detected. Both 201TI scintigraphy and serum thyroglobulin measurement should be undertaken in the follow-up evaluation of postoperative patients with thyroid cancer.

Adenocarcinoma, Papillary↗
PubMed1991

[Role of endothelial cells on refractoriness to angiotensin-II in pregnant and non-pregnant rabbits].

Vascular refractoriness to angiotensin-II (A-II) during pregnancy is well recognized. The present study was designed to evaluate how the response of endothelial cells of arterial rings to A-II changes in pregnant rabbits (n = 24) when compared with non-pregnant rabbits (n = 24). The response of the arterial rings with intact endothelium to A-II was markedly decreased in the pregnant rabbit group in comparison with the non-pregnant rabbit group. In contrast, in the case of the arterial rings whose endothelium had been removed, there was no difference between the two rabbit groups in the response to A-II. However, the maximum response of arterial rings to A-II was significantly lower in the pregnant group than the non-pregnant group under the presence of the endothelium. This study revealed that the arterial rings with intact endothelium prepared from the pregnant group shows markedly increased refractoriness to A-II, while no such difference is seen with rings from which the endothelium had been removed. That is, this study indicated that an endothelium-derived relaxing factor (EDRF) is deeply involved in refractoriness to A-II in pregnant rabbits.

Angiotensin II↗
PubMed1991

[Influence of estrogen and progesterone on the vascular response to angiotensin-II in non-pregnant rabbit vessels--intact or denuded endothelium].

During pregnancy, vascular sensitivity to A-II is reduced and it was clarified that this refractoriness to A-II is due to a change in EDRF output in pregnant rabbits. The present study aimed at elucidating whether estrogen or progesterone is responsible for the augmentation of EDRF output. 17-OH-estradiol was administered (200 micrograms/kg/day) for 7 days to 8 non-pregnant rabbits, while progesterone was similarly administered (2,000 micrograms/kg/day) to 8 other non-pregnant rabbits. Twenty-four nonpregnant rabbits were employed as the controls. Common iliac arterial rings prepared from each group were compared for the isometric response to A-II. The arterial rings with intact endothelium prepared from the progesterone-treated group were found to have a smaller pD2 value and a smaller maximum response to A-II than the estrogen-treated group. On the other hand, no differences between the progesterone group and estradiol group were observed in these values for the endothelium-denuded arterial rings. These findings indicated that the augmentation of EDRF output during pregnancy is brought about by progesterone.

Angiotensin II↗
PubMed1990

Sonography of subacute thyroiditis: changes in the findings during the course of the disease.

Fifteen patients with subacute thyroiditis were studied with thyroid sonography. There were local hypoechoic areas in all patients during the active phase of the disease. Among 6 patients who underwent follow-up studies during the course of treatment, 3 had recurrence or aggravation of clinical symptoms such as painful swelling of the thyroid region, which was associated with, and sometimes preceded by, spread or reappearance of the sonographic abnormality. All 6 patients showed complete disappearance of the hypoechoic area when they were in remission. The thyroid sonography is useful not only for the initial diagnosis but also for the follow-up of these patients during the course of the disease.

Adult↗
PubMed1990

Thyrotoxic Graves' disease with normal thyroidal technetium-99m pertechnetate uptake.

We saw 24 thyrotoxic Graves' patients with normal thyroidal uptake of technetium-99m pertechnetate (99mTc) out of 201 untreated thyrotoxic Graves' patients seen over 4 years. The clinical and laboratory findings for these patients were studied and analysed. Thyroid uptake and scintigraphic examinations by means of 99mTc, TBII and TSab activity measurement clearly distinguished these patients from other thyrotoxic disorders (destruction-induced thyrotoxicosis and autonomously functioning thyroid lesions). Different from other disorders, these patients had not lower but normal thyroid uptake and also showed diffuse and discrete trapping into the enlarged glands. These patients had significantly smaller goiters, a lower serum thyroid hormone level, and lower TBII and TSab activity, when compared with other high 99mTc uptake groups with Graves' disease, and their condition could be easily controlled with small amounts of antithyroid drugs. Our study indicates that thyrotoxic Graves' disease with normal 99mTc uptake exists and 99mTc uptake study and TBII activity measurement is very useful for the diagnosis. The normal 99mTc uptake thyrotoxic Graves' patient might be early stage patients with general Graves' disease and their early discrimination from general Graves' patients is very advantageous for treatment and prognosis.

Adult↗
PubMed1990

Sevoflurane anesthesia for elective cesarean section.

Sevoflurane anesthesia was given to sixteen women who had been scheduled for elective cesarean section. The maternal systolic blood pressure significantly decreased during the anesthesia induction. Both the anesthesia induction and emergence were smooth and rapid. These findings were supported partially by the pharmacokinetic analysis of sevoflurane concentration in the maternal artery and expired gas mixture. Spontaneous uterine contractions were good in 12 patients, fair in two and poor in two. The measured blood loss was 752 +/- 257 ml including amniotic fluid. No blood transfusion was given to any patient. The median value of the Apgar score at one minute was seven (range three to nine). No neonate was intubated for resuscitation. No abnormal maternal laboratory data were found, including liver and kidney function tests and blood cell counts one week after the operation. No adverse effect of sevoflurane on the neonate was found one week after the delivery and three months after the discharge.

Journal Article↗
PubMed1990

Presence of both stimulating and blocking types of TSH-receptor antibodies in sera from three patients with primary hypothyroidism.

A case report of three patients with primary hypothyroidism who had potent TSH-binding inhibitor immunoglobulins (TBII) and both thyroid stimulating (TSAb) and thyroid stimulation-blocking antibodies (TSBAb) has been described. Two patients displayed symptoms and signs indistinguishable from those in primary myxoedema (cases 1 and 2), and another patient had a history of Graves' disease (case 3). TBII, TSAb and TSBAb activities were 90.0, 1084.2 and 94.5% in case 1, 91.5, 826.6 and 95.8% in case 2, 76.0, 230.0 and 95.0% in case 3, respectively (normal range, less than 11.0%, less than 145.0 and less than 22.0%, respectively. The results indicate that both stimulating and blocking types of TSH-receptor antibodies exist in these patients. The possible mechanism whereby hypothyroidism developed has been discussed.

Adolescent↗
PubMed1990

Follow-up study of thyroid stimulating-blocking antibodies in hypothyroid patients.

It has been shown that hypothyroidism of some patients may be associated with increased activity of thyroid stimulating-blocking antibodies (TSBAb). The present study was undertaken to follow the course of thyroid blocking, stimulating immunoglobulins and TSH-binding inhibitor immunoglobulins (TBII) in six hypothyroid patients who had elevated TSBAb and were treated with T4. Four of the six had Graves' disease previously treated with antithyroidal drugs, one had Graves' disease treated with 131I and one had subacute thyroiditis and subsequently became hypothyroid. The patients were followed for 1-5 years. Blocking activity and TBII normalized in four of the six during T4 therapy, so T4 was discontinued and they remained euthyroid. These data indicate that it is important to monitor carefully thyroid function in hypothyroid patients treated with a fixed amount of T4 to avoid subclinical hyperthyroidism and its consequence, e.g. osteoporosis.

Adolescent↗