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Biomedical subjects

H Shimada

Publications and source records attributed to H Shimada.

At least 775 records · Page 43Linked to original sources
PubMed1989

Amyloid goiter with hypothyroidism.

Whereas the microscopic infiltration of the thyroid by amyloid is a common phenomenon, significant enlargement of the gland due to the deposition of amyloid is infrequent. Amyloid goiter usually occurs as one of the unusual manifestations of systemic amyloidosis. The rapid growth associated with local pressure symptoms often suggests malignancy. In spite of the extensive infiltration of the gland by amyloid, thyroid function usually remains euthyroid. We have recently observed an unusual case of multicentric giant lymph node hyperplasia in a patient who developed amyloid goiter with hypothyroidism. The amyloid material was of AA type.

Adult↗
PubMed1989

[Prognostic significance of histopathological classification in patients with carcinoma of the uterine cervix].

In a retrospective study of 724 patients with histologically proven carcinoma of the uterine cervix from 1980 through 1986, the histological classification and clinical stage (FIGO) were investigated for their prognostic value. The clinical stage was very important in relation to prognosis. The histological type of the squamous cell carcinoma (keratinizing, large cell non-keratinizing, small cell non-keratinizing) did not have any value in predicting survival, but small cell non-keratinizing tumor showed a less favorable prognosis than other tumors when surgery was employed. As to survival, there was no difference between adenocarcinoma and squamous cell carcinoma when compared in all patients, but adenocarcinoma had a worse prognosis than squamous cell carcinoma when surgery was employed. The pelvic lymphnode status at operation was correlated with the clinical stage. Adenocarcinoma had more positive nodes than squamous cell carcinoma. There was no significant difference in the frequency of pelvic node involvement among cell types of squamous cell carcinoma. The present histopathological classification of the uterine cervical carcinoma was of little prognostic value in predicting patient outcome.

Adenocarcinoma↗
PubMed1989

[Liver failure after hepatic resection].

Pathophysiology of hepatic resection in 89 cases was investigated from the point of endotoxemia and phagocytic function in order to clarify the mechanism of postoperative liver failure. In the control group (n = 44) and the bile stasis group (n = 9) plasma endotoxin increased to 22 to 160pg/ml early after operation and decreased thereafter: but in the liver failure group (n = 10) it increased higher corresponding to high risk operation and the massive bleeding or anastomosis leakage. In control and bile stasis groups phagocytic K value, serum CH50, plasma fibronectin decreased to half of the preoperative level on the first postoperative day, and later improved. In liver failure group these levels decreased but never improved. Liver failure group was characterized by an irreversible platelets count decrease corresponding to the increase of serum bilirubin level. It was concluded that endotoxemia in the presence of a self defence system dysfunction is thought to be a trigger for organ failure.

Complement System Proteins↗
PubMed1989

Comparative effects of chelating agents on distribution, excretion, and renal toxicity of inorganic mercury in rats.

The effects of three chelating agents, sodium N-benzyl-D-glucamine dithiocarbamate(NBG-DTC), 2,3-dimercaptopropanol(BAL), and D-penicillamine(D-PEN), on the distribution, excretion, and renal toxicity of inorganic mercury were compared in rats exposed to HgCl2. Rats were injected i.p. with 203HgCl2 (300 micrograms of Hg and 2 microCi of 203Hg/kg) and 30 min or 24 h later they were injected with a chelating agent (a quarter of an LD50). The injection of the chelating agents significantly enhanced the biliary and urinary excretions of mercury. BAL was the most effective for removal of mercury from the body at 30 min after mercury treatment. The extent of enhancing effect of the chelating agents for removal of mercury at 24 h after mercury was in the order NBG-DTC = BAL greater than D-PEN. The injection of BAL at 24 h after mercury treatment caused the redistribution of mercury to the heart and lung. NBG-DTC did not result in the redistribution of mercury to the heart, lung, and brain. Urinary excretion of protein and AST significantly increased 24-48 h after mercury treatment and decreased to the control values 72 h after mercury. The injection of the chelating agents at 30 min after mercury treatment significantly decreased the urinary excretion of protein and AST. In rats pretreated with mercury 24 h earlier, the chelating agents significantly decreased the urinary protein at 48 h after mercury treatment, but did not decrease the urinary AST. The results of this study indicate that the chelating agents are effective in removing mercury from the body, resulting in the protective effect against the mercury-induced renal damage.

Animals↗
PubMed1989

[Effects of intravitreal steroid injection on rabbit eye].

In a previous study by the authors, it was determined that irrigation solutions containing an anti-prostaglandin agent had the capability of preventing the occurrence of blood-ocular barrier disruptions, retinal edema and post-operative inflammation following vitrectomy. However, not only prostaglandins but also leukotrienes, noted for their migratory effect on leukocytes, have cell migratory effect on the retinal pigment epithelial cells. Therefore, irrigation solutions containing an anti-prostaglandin agent and a steroid are expected to have the capability of preventing the occurrence of proliferative vitreoretinopathy and post-operative inflammation after vitrectomy. In this experiment, two kinds of steroids were injected into rabbit vitreous cavities in order to evaluate toxicity and to establish the toxic intravitreal dose of steroids on intraocular tissue. After paracentesis, 36 eyes of 18 rabbits were injected with dexamethasone sodium phosphate or betamethasone sodium phosphate, suspended in 0.3 ml of distilled water. Each steroid has the same molecular weight and almost the same clinical effects. The four eyes of two rabbits received 0.3 ml of physiologic saline as a control. All eyes were observed histologically seven days after the injection. It was proved that each steroid had almost the same toxicity for the same concentration and all steroids at dose less than five mg did not show toxicity on intraocular tissue. With all steroids, 10mg produced localized retinal degeneration at the inferior region of the posterior fundus. Twenty mg caused more extensive retinal degeneration. At a dose of 80 mg each steroid caused corneal edema, degeneration of ciliary bodies, fibrin formation in the vitreous body and degeneration of retinal cells throughout the retina. Considering the osmolarity and pH of each steroid solution, it was concluded that less than five mg of each of the steroids did not cause retinotoxicity, whereas more than 10 mg of any steroid did cause retinotoxicity.

Animals↗
PubMed1989

[An unclassifiable case of hypoplastic leukemia in old age treated successfully with vincristine and prednisolone].

An 80-year-old male was admitted because of dizziness and palpitation. Laboratory investigation revealed pancytopenia. A bone marrow aspirate showed a markedly hypocellular marrow with 41.6% blast cells. Peroxidase activity was negative and PAS reaction was block positive in the blast cells. Surface markers of these cells were positive for HLA-DR antigen and partially positive for CD13 (MY7). Other markers, such as T, B or myeloid antigens were all negative. These blast cells were classified as L1 according to the FAB system but suggested essentially unclassifiable in cell differentiation. The patient was treated successfully with vincristine and prednisolone and induced into complete remission although repeated marrow examination findings revealed hypocellular. As for the classification of hypoplastic leukemia, lymphoid or primitive "stem cell" leukemia also should be considered as other categories of acute leukemias and be treated according to each case.

Aged↗
PubMed1989

Carcinoma of the gallbladder and extrahepatic bile duct in autopsy cases of the aged, with special reference to its relationship to gallstones.

To demonstrate correlation between occurrence of carcinoma and that of gallstone of the gallbladder and biliary tract, we reviewed the protocols of gallbladder and extrahepatic biliary duct carcinoma and cholelithiasis of 4,482 cases (male 2,237, female 2,245, mean age 77.7 yr) autopsied at the Department of Pathology, Tokyo Metropolitan Geriatric Hospital, during the 27 yr from 1960 to 1986. Gallbladder carcinoma was found in 94 cases, or 2.1%. The incidence was higher in the female than in the male (male 24, female 70, p less than 0.01). Gallstone of the gallbladder was found in 957 cases or 21.4%. In the male, incidences of gallbladder carcinoma and stone increased with age until the lower half of the ninety, whereas in the female, no such tendency was found after the sixties. Incidence of gallbladder carcinoma was significantly higher in the cases with cholecystolithiasis than in those without stone (p less than 0.01). Furthermore, the incidence of gallbladder stones in the cases with relatively early carcinoma was significantly higher than that of those without carcinoma (p less than 0.01). Cholesterol stones were more common than bilirubinate in the carcinoma patients. These results suggest the importance of cholecystolithiasis, especially that of the cholesterol stones, as a background factor of gallbladder carcinoma. Extrahepatic bile duct carcinomas were present in 33 cases or 0.7% (male 19, female 14, no sex preference). The incidence was significantly higher in the cases with stones than in those without stones of the extrahepatic bile ducts (p less than 0.01). However, the fact that small stones were found in the upstream portions of obstruction of biliary tracts and no stone was found at operations in the 11 operated cases suggested that stones may be secondary to the cancerous growth.

Adolescent↗
PubMed1988

cDNA cloning, nucleotide sequence and expression of the gene for arylsulfatase in the sea urchin (Hemicentrotus pulcherrimus) embryo.

Arylsulfatase is known to be synthesized in large amounts at the early gastrula stage of sea urchin development. We determined the amino acid sequence of a portion of the purified sea urchin embryonic arylsulfatase, and then isolated a cDNA clone for arylsulfatase by screening a sea urchin plutei lambda gt10 cDNA library with an oligodeoxynucleotide probe synthesized according to the determined amino acid sequence. The longest cDNA clones were selected and the nucleotide sequence determined. The cDNA is 2422 nucleotides long and encodes 551 amino acids. The deduced amino acid sequence has not sequence similarity with any of the peptides registered in NBRF peptide databank. Northern blot analysis revealed that the arylsulfatase cDNA hybridizes to a 2.9-kb mRNA. This mRNA exists in the unfertilized egg in small amounts, but markedly increases after the blastula stage preceding the increase of the arylsulfatase activity.

Amino Acid Sequence↗
PubMed1988

Adenosine, deoxyadenosine, and deoxyguanosine induce DNA cleavage in mouse thymocytes.

When thymocytes were cultured with adenosine, deoxyadenosine, or deoxyguanosine at 1 mM for 24 h, DNA cleavage at internucleosomal sites with multiples of approximately 180 bp was induced, followed by lactate dehydrogenase release into the medium. In the presence of coformycin, an adenosine deaminase inhibitor, or formycin B, a purine nucleoside phosphorylase inhibitor, DNA cleavage was induced by these nucleosides at concentrations of less than 50 microM. Other purine and pyrimidine ribo- and deoxyribonucleosides did not induce DNA cleavage or LDH release. Because thymocyte nuclei contain a Ca2+,Mg2+-dependent endonuclease, which preferentially cuts DNA in its linker regions, DNA fragmentation induced by the three purine nucleosides was suggested to occur through increased activity of the endonuclease. The DNA cleavage induced by the nucleosides required protein phosphorylation and synthesis, inasmuch as it was inhibited by an inhibitor of protein kinases, H-7, and by an inhibitor of protein synthesis, cycloheximide. The inhibition of DNA cleavage was accompanied by a reduction in lactate dehydrogenase release, suggesting a causal relationship between DNA cleavage and cell death. The DNA cleavage and subsequent cell lysis might be related to the selective thymocyte deletion observed in patients with adenosine deaminase or purine nucleoside phosphorylase deficiency.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗
PubMed1988

Clinical staging and treatment results in rhabdomyosarcoma of the female genital tract among children and adolescents.

From 1972 to 1984, 47 children and adolescents with primary tumors of the female genital tract were treated with eight different Intergroup Rhabdomyosarcoma Study (IRS I-II) protocols. These included patients with vaginal (28), uterine (ten), or vulval (nine) rhabdomyosarcoma or undifferentiated sarcomas. The mean age of patients with primary vaginal tumors was younger than 2 years. All were of the embryonal histologic subtype. The majority of these patients were treated with initial chemotherapy (vincristine, dactinomycin, +/- cyclophosphamide, +/- Adriamycin [(ADR) doxorubicin]) followed by delayed hysterectomy and/or partial vaginectomy. Among 26 patients with localized vaginal tumors, there have been six relapses resulting in one tumor-related death and one therapy-related death. The five patients with nonfatal relapse have been disease-free for from 2.5 to 6.5 years (mean, 4.4 years) since salvage therapy was commenced. The 19 patients without relapse have been continuously disease-free for 1.5 to 12 years (mean, 5.34 years: median, 6 years). No patient that received ADR initially relapsed. Ten patients, with a mean age greater than 13 years, had primary uterine sarcomas and were treated by the same chemotherapy regimens. Six with polypoid localized lesions, removed before chemotherapy, have remained disease-free for 2.5 to 6.5 years. Four, with more extensive local lesions or disseminated disease, treated with chemotherapy only, died 2 to 11 months from diagnosis. Nine patients with rhabdomyosarcomas of the vulva (age, 1-19 years) were managed by the same chemotherapy regimens +/- radiotherapy. Resection was carried out initially or after chemotherapy. Eight of these have been disease-free from 4 to 10 years (mean, 6.4 years); and one is alive with probable disease at 2.5 years.

Adolescent↗
PubMed1988

Anticoagulant therapy in recurrent cerebral embolism: a retrospective study in non-valvular atrial fibrillation.

For the prevention of recurrent embolic stroke, 23 elderly patients with non-valvular atrial fibrillation (NVAF) were treated with oral anticoagulants (warfarin) during a mean period of 3.8 years. Only one patient suffered recurrent embolism, and another had acute myocardial infarction. There was no cerebral haemorrhage during the treatment. In an untreated control group (from an autopsy series), recurrent embolic strokes occurred in 18 of 70 NVAF patients (26%) during a mean period of 1.3 years. Long-term anticoagulant therapy appears to be effective in the prevention of recurrent embolic stroke in elderly patients with NVAF.

Aged↗
PubMed1988

Unilateral hemispheric cerebral changes similar to Creutzfeldt-Jakob disease in a case of hemiconvulsion.

A 77-year-old man suffered intermittent hemiconvulsions of unknown etiology on the left side for a period of about 5 weeks. At the autopsy, there was marked neuronal loss, severe proliferation of astrocytes and spongiform changes in the right cerebral cortex. The cerebral white matter showed loosening with astroglial proliferation in areas on the same side. These neuropathological changes were slight or absent in the left cerebral hemisphere. Histopathological changes were similar to those seen in unilateral Creutzfeldt-Jakob disease (CJD). Although unilateral CJD can not be ruled out, these unilateral hemispheric changes might be induced by intermittent hemiconvulsions.

Aged↗
PubMed1988

Ganglioside variations in human liver cirrhosis and hepatocellular carcinoma as shown by two-dimensional thin-layer chromatography.

Gangliosides isolated from 5 cases of normal liver tissues, 11 cases of liver cirrhosis and 5 cases of hepatocellular carcinoma were compared in their concentrations and compositions. Quantitative analysis revealed no significant change of ganglioside levels between normal and cirrhotic liver tissues or hepatocellular carcinoma. There was also no significant difference (p greater than 0.05) between cirrhotic liver tissues and hepatocellular carcinoma. Two dimensional thin-layer chromatography of the total ganglioside preparations of liver tissues from both liver cirrhosis and hepatocellular carcinoma showed proliferation of GM2, GD3, GD1 and at least two unidentified components, named provisionally spots Nos. 1 and 2 in the present report, and loss of GM3. Sialidase treatment and thin-layer chromatography showed the components of these spots to be sialidase-labile monosialogangliosides and distinctly different from GD3 which was described elsewhere.

Aged↗
PubMed1988

Prognostic value of histopathology in advanced neuroblastoma: a report from the Childrens Cancer Study Group.

We report the histopathologic findings in 420 patients with stage III and IV neuroblastoma enrolled in Childrens Cancer Study Group trials conducted from 1980 to 1983. A prospective study of individual cytohistologic features showed that outcome was related in a statistically significant manner to mitotic rate, multi-nuclearity, foam cells, ganglion cells, necrosis, and calcification, but only the latter was consistent for both stages. A similar test of four selected published classifications indicated the greatest prognostic value for the system developed by Shimada et al to distinguish favorable from unfavorable tumors. This classification proved significant in both stages and on examination of both primary and metastatic sites. Concordance in histologic assignment of prognosis by two observers was 83%. We conclude that the Shimada classification is valid and reproducible, and that it may be useful in planning therapy in advanced neuroblastoma. Selected cytohistologic parameters and the other classifications were less strongly predictive of outcome, but are worthy of continued study.

Adolescent↗
PubMed1988

Pathologic features of extraosseous Ewing's sarcoma: a report from the Intergroup Rhabdomyosarcoma Study.

Eighty-four cases of extraosseous Ewing's sarcoma (EOE) were found during the pathology review of the Intergroup Rhabdomyosarcoma Study I and II. Patients commonly presented during or after adolescence with the most common primary sites including the trunk, extremities, and retroperitoneum. Males were slightly more affected. Histologic sections of 74 tumors in the pathology repository were re-reviewed with attention to rosette formation (positive in 18 cases) and glycogen deposition (++ in 21, + in 36, +/- in 11, and - in 2 of 70 cases examined). Fourteen tumors (7 with rosettes and 7 without) were selected for immunohistochemical and ultrastructural studies, and 13 showed single or multiple neural markers (neuron-specific enolase in 8, S-100 protein in 6, and neurosecretory-type granules in 9). These possible cases of neural EOE could be divided into three subgroups: tumor with bidirectional neuroblastic and schwannian differentiation (5 cases), tumor with monodirectional neuroblastic differentiation (7 cases), and tumor with monodirectional schwannian differentiation (1 case). EOE with a neural nature may be categorized into a spectrum of peripheral primitive neuroectodermal tumors. Clinical, histopathologic, and biologic differences between this disease and conventional sympathetic neuroblastoma are discussed.

Child↗
PubMed1988

Acute cholangitis: a histopathologic study.

We studied the histology of the liver in acute cholangitis to determine whether microscopic changes corresponded to the patients' clinical status. Thirty-four cases of acute cholangitis were divided clinically into mild and severe cases. The incidence of endotoxemia, gram-negative bacteremia, disseminated intravascular coagulation (DIC), and hepatic failure were significantly higher in the severe cases than in the mild ones. In the severe cases, the incidence of neutrophile infiltration into the sinusoids (12 of 16) and microabscesses in the lobules (11 of 16) was also significantly higher than in the mild cases. Finally, the incidence of portal thrombosis (10 of 16) and massive necrosis of the hepatic cells (5 of 16) was significantly higher in the severe than in the mild cases, especially in the patients who later died. The results suggest that neutrophilic infiltration into the sinusoid and microabscesses in the lobules is a characteristic finding in severe cholangitis.

Acute Disease↗
PubMed1988

Histopathology of childhood sarcomas, Intergroup Rhabdomyosarcoma Studies I and II: clinicopathologic correlation.

Histopathologic material from 1,782 patients registered in the Intergroup Rhabdomyosarcoma Study Committee (IRS)-I and -II were reviewed by the IRS Pathology Committee in order to provide a uniform approach to classification and correlate patient survival with tumor type. Categories considered eligible were the four types of rhabdomyosarcoma (RMS) (criteria of Horn and Enterline), extraosseous Ewing's tumor (EOE), and a group of somewhat variable undifferentiated sarcomas designated small round cell sarcoma, type indeterminate (STI). Tumors that were clearly sarcomas but were unclassifiable also were included (NOS). The committee diagnoses were embryonal (Emb) RMS in 877 (54%), alveolar (Alv) RMS in 343 (21%), botryoid (Botr) RMS in 88 (5%), pleomorphic (Pleo) RMS in 11 (1%), STI in 135 (8%), and EOE in 84 (5%). One in nine were mixtures of types, eg, Emb and Alv. Five percent of the sarcomas could not be classified because of inadequate material. In general, there was close agreement (94%) between the review committee and institutional pathologists in the diagnosis of RMS, but not in the specific types, particularly Alv RMS (41%) and STI (36%). This observation is important, since patients with Alv RMS and STI tumors had decreased survival compared with the other histologies. The prognosis varied by histology, with Botr having the best, Alv RMS and STI the worst, and Emb RMS and EOE an intermediate prognosis.

Age Factors↗