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Biomedical subjects

H Nishitani

Publications and source records attributed to H Nishitani.

At least 145 records · Page 8Linked to original sources
PubMed1990

[A case of polymyositis associated with chronic active hepatitis].

A case of polymyositis associated with chronic active hepatitis was reported. A 53-year-old man, who had no previous history of blood transfusion nor hepatitis, noticed proximal dominant muscle weakness on January 29, 1985. He was admitted to Kyoto National Hospital on February 7, and laboratory studies disclosed the elevation of serum enzyme levels; creatine kinase (CK) 9845 IU/L (normal 54-263), glutamate oxaloacetate transaminase (GOT) 834 IU/L (9-31), glutamate pyruvate transaminase (GPT) 491 IU/L (4-34), lactate dehydrogenase (LDH) 2135 IU/L (248-464). Also serum gamma globulin was high (1.8 g/dl) and LE-like cell was found. The diagnosis of polymyositis was made and prednisolone therapy (60 mg/day) was started on February 23. The elevated serum enzymes decreased gradually, but severe muscle weakness persisted for about one month. On April 3, he was admitted to our hospital. Physical examination revealed moderate proximal dominant muscle weakness without skin eruption, jaundice or hepatosplenomegaly. The serum enzymes were still high; CK 1826, GOT 173, GPT 232 (GOT less than GPT), LDH 1548. However, alkaline phosphatase (ALP) and bilirubin were normal. Hepatitis B surface antigen (HBsAg) was not detected. Antinuclear antibody was positive. The electromyogram study showed myopathic change, and the muscle biopsy demonstrated myopathic change and cell infiltration, compatible with polymyositis. These results suggested liver dysfunction associated with polymyositis. Prednisolone therapy was continued and muscle weakness decreased. From December, 1985, serum enzymes (CK, GOT, GPT, LDH) elevated again and muscle weakness also slightly increased. Anti-smooth muscle antibody was positive. It was suggested that both polymyositis and liver dysfunction deteriorated.(ABSTRACT TRUNCATED AT 250 WORDS)

Autoantibodies↗
PubMed1990

Binding activity and autophosphorylation of the insulin receptor from patients with myotonic dystrophy.

To clarify a mechanism of insulin resistance associated with myotonic dystrophy, we studied the insulin receptor by using three different types of cells--circulating erythrocytes, cultured skin fibroblasts, and Epstein-Barr virus(EBV)-transformed lymphocytes. In myotonic dystrophy, insulin binding to erythrocytes and fibroblasts was significantly decreased as a result of a reduction of the binding affinity. Insulin binding to EBV-transformed lymphocytes was normal. When the receptors were purified from fibroblasts with wheat germ agglutinin, we could not find a decrease in the binding affinity seen in the intact cells. No difference was observed in the magnitude of basal and insulin-stimulated autophosphorylation of insulin receptors from EBV-transformed lymphocytes between the control and myotonic dystrophy. Southern blot analysis of the insulin receptor gene revealed no restriction fragment length polymorphism associated with myotonic dystrophy. These findings suggest that there is no primary defect of the insulin receptor per se in terms of insulin binding and autophosphorylation in myotonic dystrophy. The reduction of the insulin binding to erythrocytes and fibroblasts may be caused by the plasma membrane abnormality that affects the binding affinity of the receptor.

Adult↗
PubMed1990

The risk of development of HTLV-I-associated myelopathy/tropical spastic paraparesis among persons infected with HTLV-I.

Using data obtained in national surveys of human T-lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) conducted in Japan in 1987 and 1988, we estimated the yearly and lifetime risk that HAM/TSP will develop in an HTLV-I-infected person. "Definite" HAM/TSP was defined as slowly progressive myelopathy with antibodies to HTLV-I in both serum and cerebrospinal fluid. Estimates of HTLV-I infection rates in eight endemic prefectures, by age group and sex, were obtained from serologic studies of blood donors; population figures, by age group, sex, and prefecture, were obtained from the census. Of 589 definite cases of HAM/TSP reported nationally, 397 occurred in residents of the eight endemic prefectures; of these, 170 reported onset of illness during the years 1982-1988 (average incidence, 24.3 cases/year). Using the estimated HTLV-I infection rates and the 1985 census figures, we estimated the number of HTLV-I-infected persons in the eight prefectures in 1985 at 794,800. We therefore estimated the incidence of HAM/TSP among HTLV-I-infected persons at 3.1 x 10(-5) cases/year; assuming a lifetime of 75 years, the lifetime incidence is approximately one quarter of 1%. This estimate is important in counseling persons such as blood donors found to be infected with HTLV-I.

Adolescent↗
PubMed1990

[Membranous and respiratory bronchiole disease in patients with normal air-flow and mild air-flow limitation].

In order to evaluate the role of membranous (MB) and respiratory bronchioles (RB) in patients with normal and mild airflow limitation, we quantitatively assessed the pathological change of MB, RB and alveoli in the pathological specimens of 42 patients who required surgery for removal of a solitary pulmonary nodule. We also measured the destructive index (DI), to evaluate the destruction of alveolar walls. High resolution CT scan and pulmonary function tests were performed within 1 month of resection. Results of the pulmonary function tests correlated with pathological changes of RB better than with MB. Significant correlation between the emphysema score of resected lung and the pathological change of MB and RB was observed. There was also significant correlations between the CT score or DI and RB changes. However, there was no significant correlation between the CT score or DI and the change of MB. There were significant differences between smokers and nonsmokers in the results of pulmonary function test, pathological changes of RB and severity of emphysema. We postulate that RB is responsible for subtle functional abnormalities in the early stages of chronic obstructive pulmonary disease.

Adult↗
PubMed1990

Enzyme immunoassay for measuring antibodies against skeletal muscle in patients with myasthenia gravis.

We developed a highly sensitive enzyme immunoassay (EIA) for measuring IgG and IgM antibodies against human skeletal muscle (SM) component and tested sera from 100 patients with myasthenia gravis (MG), 59 with thymoma and 41 without thymoma. We found that the frequency of anti-SM IgG antibodies was significantly higher in MG patients with (81%) than without (37%) thymoma. The titers of the anti-SM IgG antibodies measured by EIA correlated well with those measured by RIA (r = 0.81, P less than 0.01). We also found that 12% of the myasthenic patients with thymoma and 15% without it had anti-SM IgM antibodies. There was no correlation between the titers of the IgG and IgM antibodies. Our EIA provides a measure of anti-SM antibodies that is of comparable sensitivity to that of RIA.

Antibodies, Anti-Idiotypic↗
PubMed1990

Improved radioassay of anti-acetylcholine receptor antibody: application for the detection of extremely low antibody titers in sera from patients with myasthenia gravis.

We examined sera from 113 patients with myasthenia gravis (MG). Most of the patients with ocular MG without thymoma and 15% of the patients with generalized MG had immunoprecipitation (IP) titers of anti-acetylcholine receptor (anti-AChR) antibodies within the normal range for healthy subjects. We developed a highly sensitive radioassay using Staphylococcus aureus cells, and re-examined the 86 serum samples that had negative titers by IP. Using the radioassay, we detected anti-AChR antibodies in 27 (31%) of these myasthenic sera, of which 19 were from ocular MG patients without thymoma. By combining the standard IP assay and our new radioassay, we increased to 50% the overall percent positivity of detecting nonblocking-type antibodies in ocular MG patients without thymoma. We detected no anti-AChR antibodies in nearly all patients with various immunological and neurological diseases other than MG, and in all the healthy controls. The data for these sera indicate that in some cases the standard IP assay gives false-negative reactions. Thus, use of the more sensitive radioassay is preferable for accuracy.

Acetylcholine↗
PubMed1989

[Usefulness of dual-energy digital radiography in detecting atlas and axis].

Cranial dual-energy digital radiography was applied to three patients. The anatomy of the atlas and axis was clearly recognized without utilizing the open-mouth view. We consider it a very effective technique when applied to the patient who experiences difficulty in opening the mouth, like severe traumatic or infantile patients. In addition, it is a useful examination for patients with suspected anomalies of cranio-vertebral junction.

Axis, Cervical Vertebra↗
PubMed1989

In vivo CNS demyelination mediated by anti-galactocerebroside antibody.

The mechanism of antibody-mediated central nervous system (CNS) demyelination in vivo was studied using rabbit eyes. Injection of anti-galactocerebroside (Gal C) antiserum alone into the normal rabbit vitreous body induced demyelination in the epiretinal myelinated fibers. This activity of the antiserum disappeared after heat treatment at 56 degrees C for 30 min and was restored by supplement of normal fresh serum, suggesting the complement dependency of the activity. Heated anti-Gal C antiserum could induce demyelination, however, when macrophages were introduced by injecting lymphocyte supernatants together with antiserum. Electron microscopic study revealed penetration of macrophage process between the myelin lamella. These findings suggest that the cooperation of anti-Gal C antibody and macrophage can result in the antibody-dependent cell-mediated demyelination in the absence of complement. Because oligodendrocyte generally appeared normal, myelin, not oligodendrocyte is suspected to be the primary target by anti-Gal C antiserum. In contrast, neither anti-MBP nor anti-gangliosides antiserum had the in vivo-demyelinating activity. In CNS demyelination by anti-Gal C antibody, complement-mediated and macrophage-mediated mechanisms may cooperate in varying degrees.

Animals↗
PubMed1989

Second interim report of the nation-wide collaborative study on the long-term effects of bromocriptine in the treatment of parkinsonian patients.

The interim data obtained up to the end of the 2nd year of the nation-wide multicentric cooperative study on the long-term effects of bromocriptine in parkinsonian patients revealed the following results. Firstly, the bromocriptine monotherapy could be continued in about 40% of the patients at the mean maintenance dose of 10.8 mg daily. Secondly, the additional use of bromocriptine in parkinsonian patients already treated with levodopa had a favorable influence on late side effects of levodopa such as on-off phenomenon and dyskinesia. No significant difference has been found so far as to the management of the wearing-off phenomenon between the patients with levodopa alone and those with levodopa and bromocriptine.

Adult↗
PubMed1989

[Comparison of high resolution computed tomography and pulmonary function tests in diagnosis of mild emphysema].

To assess the ability of high resolution CT scan and pulmonary function tests in detecting and grading mild emphysema, we correlated the high resolution CT scan and pulmonary function tests with the pathologic grade of emphysema and the destructive index of lung specimens from 42 patients undergoing thoracotomy for solitary pulmonary nodules. Using the high resolution CT scan, we could identify the pathologic grade of mild and moderate emphysema. By measuring diffusing capacity per unit alveolar gas volume (DLco/VA), it seemed to be possible to detect the mildest degree of alveolar destruction assessed by the destructive index, which was not detected by high resolution CT scan. The reason for these results seemed to be that we assessed the severity of emphysema by detecting the air space enlargement on high resolution CT scan images caused by the destruction of alveolar walls, which were detectable by measuring DLco/VA. We conclude that it is possible to detect mild emphysema using the combination of high resolution CT scan and pulmonary function tests.

Adult↗
PubMed1989

[Long-term survival of a patient with pseudoaneurysm of the left ventricle following myocardial infarction].

A 76-year-old man had an extensively calcified left ventricular pseudoaneurysm which was a sequela of acute myocardial infarction suffered 22 years ago. He experienced acute anterolateral myocardial infarction in January 1964. In March 1964, the presence of a left ventricular aneurysm was suspected by chest radiography and fluoroscopy. He was, however, in good health since then. In April 1986, when he was admitted for treatment of acute bronchitis, a large calcified density was found in the left ventricular region on chest radiography. The electrocardiogram was compatible with an old anterolateral myocardial infarction. Two-dimensional echocardiography showed an immobile portion of the left ventricle which contained "moya-moya" (sluggish, smoky) echoes. A saccular aneurysm of the left ventricle was confirmed by radioisotope cardiac pool scans, reconstruction CT and left ventriculography. Due to the poor general condition of the patient, we followed his course without surgery. He died in October 1986. At autopsy, the pseudoaneurysm was markedly calcified, and its wall was adherent to the parietal pericardium. Histologically, the pseudoaneurysmal structure turned out to be a pseudoaneurysm since the saccular wall contained only scar tissue but no myocardial cells. This is a very rare case of a patient with a left ventricular pseudoaneurysm who survived for 22 years after its occurrence.

Aged↗
PubMed1988

Aluminum transport and dialysance during haemodialysis.

Aluminum transfer and dialysance during haemodialysis and plasma aluminum concentrations in haemodialysis patients were examined. Plasma aluminum in 30 volunteer outpatients tended to decrease after 5-hour dialysis (6.35 +/- 3.02 micrograms/dl before haemodialysis; 5.41 +/- 2.60 micrograms/dl after haemodialysis). The decrease was mainly due to diffusion despite haemoconcentration evidenced by a significant increase in the haematocrit and total plasma protein during dialysis. To study the changes resulting from diffusion, we measured aluminum in the arterial blood and in the dialysate at the inflow and outflow sites of the dialyzer. There was a non-significant decrease in the plasma aluminum of arterial blood from 6.20 +/- 2.90 to 5.64 +/- 2.55 micrograms/dl, but a significant increase in the dialysate aluminum from 0.38 +/- 0.18 micrograms/dl to 1.10 +/- 0.66 micrograms/dl. Aluminum diffused across the dialyzer from the blood to the dialysate in 23 cases and into the blood in 7 others. When aluminum dialysance is high, plasma aluminum can be removed to the dialysate during haemodialysis.

Aluminum↗
PubMed1988

Comparison of angiography and computed tomography using new morphologic criteria in staging of renal cell carcinoma.

The staging of tumor extension, and regional lymph node and venous involvement by angiography and computed tomography (CT) using new morphologic criteria were compared with the surgical and histopathologic stage in 59 patients (60 cases) with renal cell carcinoma. A high degree of accuracy in staging of both angiography and CT was demonstrated. However, CT was more accurate and sensitive than angiography in the evaluation of tumor extension and regional lymph node involvement, and equally accurate in that of venous involvement. We emphasize that new morphologic criteria of angiography and CT are clinically useful, and CT is the primary approach for the staging of renal cell carcinoma.

Angiography↗