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Biomedical subjects

B Kishino

Publications and source records attributed to B Kishino.

35 records · Page 2Linked to original sources
PubMed1984

The differential diagnosis of cystic neck masses by the determination of thyroglobulin concentrations in the aspirates.

Thyroglobulin (Tg) concentrations in the aspirates of various types of cystic neck masses were measured by RIA to assess the usefulness of this determination in differential diagnosis. The subjects consisted of 16 patients, whose final diagnoses were all established on the basis of operative results; three patients had follicular thyroid adenomas (F-Ad), 11 had papillary thyroid carcinomas (P-Ca), one had a thyroglossal duct cyst (TDC) and one had a lateral cervical cyst (LCC). Tg concentrations in the cyst fluids of F-Ad and P-Ca were very high (0.042-2.83 mg/ml) compared with serum Tg concentrations. There was no difference in Tg concentrations in the fluids of P-Ca between primary lesions (n = 5) and metastatic lesions (n = 6). On the other hand, Tg concentrations of TDC and LCC were very low (less than 100 ng/ml). Difficulty was experienced in diagnosing three patients, even though they had been examined by all nonsurgical diagnostic techniques. However, an occult thyroid carcinoma with lymph node metastasis was diagnosed by demonstrating a high Tg concentration in the aspirate of the cystic lymph node. T3 concentrations in cyst fluids of F-Ad were higher than those of P-Ca. T3 concentrations in the fluids of P-Ca, TDC and LCC did not differ, and were similar to serum T3 levels. Cytology of cyst fluids was positive in four of 10 patients examined with P-Ca. In conclusion, we can clearly confirm the thyroid origin of a cystic neck mass by demonstrating a high Tg concentration in the aspirate. This is especially useful for diagnosis in patients with thyroid carcinoma, including occult thyroid carcinomas with cystic lymph node metastasis.

Adenoma↗
PubMed1983

Effects of probucol on homozygous cases of familial hypercholesterolemia.

A marked reduction of serum cholesterol was obtained by treatment with probucol in heterozygous as well as in homozygous cases of familial hypercholesterolemia. A strict dietary regimen (low-fat, low-calories) intensified the hypocholesterolemic effect of the drug. The drug was also useful in diminishing the rebound of serum cholesterol after plasma exchange. Probucol reduced serum triglycerides in heterozygous cases of familial hypercholesterolemia, but there was a slight increase in triglycerides in homozygous cases. Treatment with probucol resulted in the regression of cutaneous and tendon xanthomas. Although it caused a decrease in HDL, it seems to be very effective in the treatment of familial hypercholesterolemia.

Adolescent↗
PubMed1983

Serum thyroglobulin changes in patients with Graves' disease treated with long term antithyroid drug therapy.

In 29 patients with thyrotoxic Graves' disease treated with conventional long term antithyroid drug therapy, serum thyroglobulin (Tg) was serially determined by RIA and compared with clinical course, goiter shrinkage, and 131I uptake suppression. Those subjects with Tg autoantibody-negative sera comprised 46% of the patients with Graves' disease. They were divided into a remission group (G I) and an exacerbation group (G II). G I was subdivided into G Ia, who were in remission for 7-40 months, and G Ib, who relapsed more than 15 months after therapy. G II was still on therapy 27-62 months after its initiation, because these subjects exacerbated on reduction of the drugs. Goiter shrinkage occurred in 60% and 0%, and 131I uptakes were suppressed by T3 in 50% and 0% in G I and G II, respectively. Serum Tg in G I declined progressively and reached 48 +/- 5 (+/-SE) ng/ml on discontinuation of therapy, in sharp contrast with serum Tg in G II which remained high throughout (154 +/- 29 ng/ml at the last examination; P less than 0.001). Results of goiter shrinkage, 131I uptake suppressibility, and serum Tg levels were similar in G Ia and G Ib on cessation of therapy. Serum Tg levels less than 68 or more than 140 ng/ml on discontinuation of therapy were helpful in predicting the outcome of therapy. On the other hand, Tg levels were low and goiters were small in size in euthyroid Graves' disease. Tg levels were not clearly correlated with goiter weight or serum T4 and T3 levels before treatment. In conclusion, serial determinations of serum Tg reflect thyroid activity and provide information useful in the decision to discontinue therapy and observation after that.

Adult↗
PubMed1983

[Fine needle aspiration of neck tumor. Application of cytological, bacteriological and hormonal examinations].

Aspiration of neck tumors with a fine needle combined with cytological, bacteriological and hormonal examinations greatly improved the accuracy of the differential diagnosis of the neck tumors. Fine needle aspiration cytology in 45 patients with thyroid tumor gave only 4% (1/25) false negative diagnosis and 0% (0/20) false positive diagnosis for carcinoma, whereas false negative and false positive diagnosis by palpation were 34% and 4%, respectively and those by soft tissue roentgenogram were 55% and 0%, respectively. Differential diagnosis of histological types of thyroid carcinoma was possible by cytology. Fine needle aspiration of cervical lymph nodes gave the diagnosis of malignant lymphoma, metastatic squamous cell carcinoma, adenocarcinoma or inflammatory changes. Bacterial culture from the aspirate yielded causative microorganism in 5 patients including 4 with tuberculosis. The specimens aspirated from thyroglossal duct cysts or branchial cysts showed specific appearance and cytological feature. The aspirate from a parathyroid cyst was watery clear and contained high amount of parathyroid hormone. Dark brown serous aspirate from extrathyroidal mass suggested metastatic lesion from occult papillary carcinoma of the thyroid in 2 patients. Demonstration of very high content of thyroglobulin of the aspirate determined by radioimmunoassay supported the diagnosis, which was confirmed later at surgery. This method has become a routine work in our out-patient clinic.

Adenocarcinoma↗
PubMed1982

Increased norepinephrine content in diabetic rat heart.

In an attempt to clarify the mechanism of cardiac neuropathy in diabetes mellitus, Wister male rats were made diabetic by streptozotocin injection for 11 to 13 weeks, and catecholamine concentrations of hearts were determined by high performance liquid chromatography. No apparent histological changes were found in hearts and kidneys of any group of rats. Controls used were age-matched normal rats and Goldblatt-hypertensive rats, because streptozotocin induced diabetic rats appeared to be significantly hypertensive. Heart norepinephrine concentrations of diabetic rats and diabetic-Goldblatt-hypertensive rats were markedly higher (8,380 +/- 300 pmol/g tissue and 6,980 +/- 390, respectively) compared with those of controls and Goldblatt-hypertensive rats (2,700 +/- 470 and 2,010 +/- 300, respectively). These results suggest some disturbances in catecholamine secretion in diabetic hearts before typical microangiopathic changes take place.

Animals↗
PubMed1982

Effects of iodide and propylthiouracil on the release of 3,5,3'-triiodothyronine and of cyclic adenosine 3',5'-monophosphate from perifused rat thyroids.

We have established a perifusion system using rat thyroid. With this system, we analyzed the effects of TSH, 3-isobutyl-1-methylxanthine (IBMX) and iodide on the release of T3 and of cAMP, paying special attention to the relation between the release of the two substances. During perifusion, which was continued for 7 h, T3 release increased progressively with time and in a dose-related manner when TSH was added at concentrations of 0.1-10 mU/ml. However, cAMP release was unappreciable even in the presence of 10 mU/ml TSH. The release of T3 and cAMP was markedly enhanced by 3 x 10(-4) M IBMX. When iodide was added, a marked increase in cAMP release was unexpectedly observed. However, a slight but significant suppression of TSH-stimulated T3 release was shown with 1 x 10(-3) M iodide. TSH-stimulated T3 release was almost completely inhibited by 1 x 10(-3) M 6-n-propyl-2-thiouracil, but such a complete inhibition did not occur with 2-mercapto-1-methylimidazole. The cAMP release stimulated by IBMX was not affected by 6-n-propyl-2-thiouracil, but that stimulated by iodide was effectively inhibited. The present studies indicate that TSH and IBMX enhance T3 release, but only IBMX increases cAMP release. Iodide also results in a marked increase in cAMP release but does not affect T3 release from unstimulated thyroid and inhibits T3 release from TSH-stimulated thyroid. We suggest that there is not necessarily any close correlation between T3 release and cAMP release into perifusates of the rat thyroid.

1-Methyl-3-isobutylxanthine↗
PubMed1982

Decreased response of plasma catecholamine to stress in diabetic rats.

Previously we reported that the heart norepinephrine concentration was markedly increased in diabetic rats. To further study the relationship between a disturbance in the autonomic nervous system and catecholamine metabolism in diabetes mellitus, the plasma catecholamine response to stress and catecholamine concentration of heart and adrenals were measured. Wistar male rats were made diabetic by streptozotocin and kept for 13 weeks. A silicon catheter was placed in the superior V. cava 1 week prior to the experiment. Insulin was injected subcutaneously for 3 days once daily. After an overnight fast and without anesthesia, 1 ml of blood, a control sample, was obtained and then the animals were exsanguinated. The blood was mixed with 1 mM EGTA at a final concentration and centrifuged. The tissue was homogenized with 0.4 N perchloric acid containing 1 mM EGTA and centrifuged at 10,000 x g for 20 minutes. Catecholamines were determined by high performance liquid chromatography. Normal rats responded to blood withdrawal stress, and plasma catecholamines were markedly increased, but almost no increase or an actual decrease was observed in diabetic rats. These abnormal responses were improved by insulin treatment. Heart norepinephrine was increased significantly in the diabetic rats compared with the control rats and was reduced significantly by insulin injections. Adrenal epinephrine was also significantly increased in the diabetic rats compared with the control rats, but was not significantly reduced by insulin. These result suggest a possible disturbance of catecholamine secretion in the diabetic rats.

Adrenal Glands↗
PubMed1978

[A radioimmunoassay for the measurement of thyroglobulin in human serum and its application to clinical study (author's transl)].

A sensitive and specific double antibody radioimmunoassay for the measurement of serum thyroglobulin (Tg) has been developed. The minimum detectable concentration of Tg was 5.0 ng/ml. Coefficients of within and between assay variation were 2.4% and 12.0%, respectively. The mean recovery of Tg added to normal serum was 102.9%; and T4, T3, DIT and MIT did not crossreact in this assay system. Dilution curves of normal thyroid extract, tumor extract and patient's serum were shown to be parallel with the standard Tg preparation. The mean serum Tg level in normal males and females was 42.8 +- 5.3 ng/ml (mean +- SE) (N=29) and 117.1 +- 20.9 ng/ml (N=20), respectively. There was a significant difference between male and female groups (p less than 0.001). The mean serum Tg level was 365.0 +- 69 ng/ml in 19 hyperthyroid patients with Graves' disease and 248.1 +- 35.8 ng/ml in 21 patients who were in a euthyroid state from the treatment with antithyroid drugs, showing statistically no significant difference. However, 8 patients in permanent remission showed definitely low Tg values, 83.6 +- 16.2 ng/ml. The mean serum Tg level was 2101.1 +- 57.6 ng/ml in 6 patients with chronic thyroiditis without auto-anti Tg and 525.1 +- 207.5 ng/ml in 5 patients with thyroid adenoma. The effect of total thyroidectomy on the serum TSH and Tg was studied in a patient (M.T.) with pulmonary metastases from thyroid follicular adenocarcinoma. The serum TSH level rose progressively to hypothyroid levels during nine days after thyroidectomy; the value was 45.7 muU/ml on the 9th day after the thyroidectomy. The serum Tg level in this case was 4 925 ng/ml before surgery. After a transient fluctuation caused by the operation, the serum Tg level in the patient increased progressively during 39 days after surgery with a concomitant increase in serum TSH; the levels at the 3rd, 6th and 9th day after surgery were 5,825 ng/ml, 7,910 ng/ml and 11,190 ng/ml, respectively. The suppression of endogenous TSH secretion with treatment of T3 60 MICROGRAMS/DAY WAS FOLLOWED BY A GRADUAL FALL In serum Tg levels, decreasing to 630 ng/ml at the 114th day. Bovine TSH was administered to this patient at the 114th day, so as to study the effect of exogeneous TSH on serum Tg. Serum Tg reached a maximal peak at the 24 hr. after bovine TSH injection. The maximal increase of serum Tg above baseline was 221%. Despite complete removal of the thyroid gland, the increase in serum Tg after thyroidal stimulation with endogenous and exogenous TSH was observed in the patient. In addition, the increase in serum Tg after bovine TSH injection was also observed in two patients with differentiated thyroid carcinoma who underwent a total thyroidectomy and had only metastatic tissue. These results indicate that the elevated serum Tg was released from metastatic tissue by TSH. The present study demonstrates direct evidence that metastatic tissue from thyroid carcinoma is responsive to TSH...

Adenocarcinoma↗
PubMedDate not supplied

Routes of infection of acute suppurative thyroiditis diagnosed by barium examination.

A fistula between the left pyriform sinus and the left thyroid gland region has been reported to be the route of infection in several cases of acute suppurative thyroiditis. Another four patients with acute suppurative thyroiditis have been encountered in whom a fistula from the hypopharynx was demonstrated radiographically. In three patients the fistulous tract was situated on the right side, and in one of these cases the fistula originated from the epiglottic vallecula rather than the pyriform sinus. These locations have not been reported earlier. Endoscopic examination was valuable for confirming the diagnosis.

Adult↗
PubMedDate not supplied

CA125-positive papillary tumor of the peritoneum.

A 71-year-old female visited our outpatient unit with chief complaints of anorexia and a sense of abdominal distension. The abnormalities found after admission were conspicious increases in CA125 levels in serum and ascites as well as anemia, accelerated erythrocyte sedimentation and increased serum LDH. The patient underwent an emergency operation for ileus. The histological diagnosis was serous papillomatous cancer. Immunohistologic staining of the cancer tissue demonstrated the production of CA125. In this very rare the remnant of the Müllerian duct in the peritoneum is thought to have been cancerous.

Aged↗
PubMedDate not supplied

[Intravascular malignant lymphomatosis: an autopsy case with generalized telangiectasia and various neurological manifestations].

We report a 73-year-old woman with intravascular malignant lymphomatosis (IML) who showed generalized telangiectasia as well as various neurological symptoms. In July 1998, she developed fever, dizziness, and confusion followed by left hemiparesis, and was admitted to our hospital on August 11, 1998. Laboratory tests indicated a normochromic normocytic anemia, thrombocytopenia, elevated serum lactic dehydrogenase (LDH), C-reactive protein (CRP), and cerebrospinal fluid protein. Magnetic resonance imaging (MRI) of the brain revealed an infarct-like lesion in the left frontal lobe and multiple white matter lesions. After admission, her neurological status deteriorated and lapsed into coma and quadriplegia. At the end of September 1998, generalized telangiectasia appeared, and she was diagnosed as IML on skin biopsy. Although combination chemotherapy failed to improve her neurological symptoms, telangiectasia disappeared in a few days, and the infarct-like lesion on MRI decreased in size. Serum LDH, CRP, and thrombocyte counts were normalized. Autopsy findings revealed perivascular clustering of B cell type lymphoma cells in the left frontal lobe where abnormal signal intensity was found on MRI, as well as the spleen and the bone marrow. This case emphasizes the importance of early diagnosis and treatment in IML.

Aged↗