Biomedical subjects

H Shishido

Publications and source records attributed to H Shishido.

At least 73 records · Page 4Linked to original sources

PubMed1991

Myeloid progenitor cell growth characteristics and effect of G-CSF in a patient with congenital cyclic neutropenia.

A 17-year-old male with congenital cyclic neutropenia was treated with recombinant human granulocyte colony stimulating factor (G-CSF) administered subcutaneously at 1 to 2 micrograms/kg per day. The peak and nadir counts of neutrophils and the peak counts of monocytes were significantly elevated, and the period of cycling decreased from 3 to 2 weeks. Bone marrow culture studies revealed the following abnormalities in granulocytic progenitor cells (CFU-G): a decrease in the concentrations of G-cluster forming cells, stimulated by a maximal dose of G-CSF, and a tendency of abnormally low responsive growth of the CFU-G to lower concentrations of G-CSF and GM-CSF. Our findings suggest that administration of G-CSF at relatively low doses overcomes or compensates for these abnormalities, though not completely, as fluctuation in the neutrophil counts persisted.

Bone Marrow↗

PubMed1990

Fine structural localization of RNA in myeloma cells detected by the enzyme-gold method.

The ultrastructural localization of RNA in myeloma cells was studied by the RNase-gold method. Gold particles indicating the presence of RNA were observed in large numbers, particularly in the granular component of the nucleolus and periphery of the rough endoplasmic reticulum, but not in the Golgi area, mitochondria, intranuclear inclusion bodies, cytoplasmic inclusion bodies, dense bodies, or cisternae of the rough endoplasmic reticulum. In the nuclear chromatin and nucleolus, gold particles were more numerous as these structures were less mature. They were found in larger numbers also in the cytoplasm of immature cells. In plasma cells from patients with macroglobulinemia, gold particles were fewer than in myeloma cells of multiple myeloma, but there was no difference in their distribution pattern.

Adult↗

PubMed1990

Vertebrobasilar insufficiency: stable xenon computed tomography-cerebral blood flow study in posterior circulation revascularization.

Preoperative and postoperative local cerebral blood flow were measured by the stable xenon computed tomography-cerebral blood flow technique in 15 patients with vertebrobasilar insufficiency. The surgery included end-arterectomy or angioplasty of the vertebral artery (five cases), superficial temporal artery-superior cerebellar artery anastomosis (eight cases), and superficial temporal artery-posterior cerebral artery anastomosis (two cases). Fourteen (93.3%) of the 15 patients improved in the post-operative period. Low local cerebral blood flow in the ischemic area without infarction manifested a constant and significant increase postoperatively. In summary, the stable xenon computed tomography-cerebral blood flow technique is thought to be a simple and useful method for assessing local cerebral blood flow in posterior circulation perioperatively.

Aged↗

PubMed1990

Interleukin 5 activity in sera from patients with eosinophilia.

Sera from 10 patients with eosinophilia contained eosinophil colony stimulating factor (Eo-CSF) activity. Using anti murine (m) interleukin-5 (IL-5) antibody, we demonstrated that this activity was mainly derived from IL-5. Administration of prednisolone to patients decreased both Eo-CSF activity in sera and the number of eosinophils in blood. These results extend our recent study demonstrating that T cells from eosinophilic patients produce IL-5 with IL-2 stimulation and may support the speculation that IL-5 is an important factor which induces eosinophilia.

Blood Cell Count↗

PubMed1990

Interaction of monocytes and T cells in the regulation of normal human megakaryocytopoiesis in vitro: role of IL-1 and IL-2.

Autologous or allogeneic peripheral blood T cells can stimulate the human megakaryocyte progenitor cell (CFU-Meg)-derived colony formation in a dose-dependent fashion in agar cultures of nonadherent (NA), T cell-depleted (NT) bone marrow (BM) cells. Low concentrations of monocytes and T cells can collaborate in the stimulation of CFU-Meg colony formation or in the production of megakaryocyte colony stimulating factor (Meg-CSF) by T cells in the presence of mitogens or IL-2. Monocytes alone can produce only negligible Meg-CSF under any conditions. When monocyte conditioned medium (CM) was added to T cell-stimulated NA, NT BM cell cultures, CFU-Meg colony growth was appreciably increased compared with that stimulated by T cells alone. Dose-dependent increase in CFU-Meg colony growth was noted when varying concentrations of IL-1 were added to T cell-stimulated NA, NT cell cultures, although IL-1 itself could support no CFU-Meg colony growth in the absence of T cells. These data suggest that a synergistic interaction between T cells and monocytes during the production of Meg-CSF by T cells could be partly mediated by IL-1. IL-2 was found to stimulate Meg-CSF production by T cells in the presence or absence of mitogens. IL-2-stimulated Meg-CSF production by T cells was augmented by the addition of monocytes. Although IL-2 itself had no stimulatory effect on CFU-Meg colony growth, dramatic augmentation in the CFU-Meg colony number was noted when IL-2 was added to T cell-stimulated NA, NT cell cultures. High concentrations of monocytes and prostaglandin E (PGE) inhibited the CFU-Meg colony formation. These results suggest that IL-1 and IL-2 may play a stimulatory role on the normal human in vitro megakaryocytopoiesis, and may be involved in the development of reactive thrombocytosis and bone marrow megakaryocytic hyperplasia in various inflammatory diseases.

Cell Communication↗

PubMed1990

Hemodynamic evaluation in patients with superficial temporal artery-middle cerebral artery anastomosis--stable xenon CT-CBF study and acetazolamide.

Sixteen patients with minor completed stroke in the chronic stage underwent superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. The acetazolamide-activated regional cerebral blood flow (rCBF) was measured 20 minutes after the injection using inhalation of stable xenon and computed tomographic scanning (Xes CT-CBF study) pre- and postoperatively. Eleven patients (Group 1) showed immediate improvement in neurological state within a few days of the operation, while five (Group 2) showed no improvements. Preoperative rCBF in the ischemic areas without infarction was 30.8 +/- 3.0 ml/100 gm/min in Group 1 and 53.0 +/- 5.2 ml/100 gm/min in Group 2. Preoperative vasodilatory capacity with acetazolamide in Group 1 was 5.7 +/- 8.6 and significantly increased to 19.8 +/- 4.9 after surgery. In Group 2, pre- and postoperative vasodilatory capacity was 12.7 +/- 3.1 and 14.9 +/- 2.9, respectively, and there was no significant change. These results suggested that minor stroke patients with moderate decrease of affected side rCBF (less than 40 ml/100 gm/min) and with hemodynamic impairment may have the surgical indication for STA-MCA anastomosis.

Acetazolamide↗

PubMed1990

Measurement of energy expenditure in acute stage of cerebrovascular diseases.

Oxygen consumption (VO2), carbon dioxide production, respiratory quotient, urinary nitrogen excretion (UN), resting energy expenditure (REE), REE rate (%REE) and consumption rates of carbohydrate (%C), fat (%F) and protein (%P) were pre- and postoperatively measured in the acute stage of 17 patients with cerebrovascular diseases. They included six of ruptured intracranial aneurysms, six of cerebrovascular occlusion, and five of hypertensive intracerebral hemorrhage. Preoperative VO2, UN, REE, and %REE were 185.1 ml/min, 7.1 gm/day, 1280 cal/day, and 132.6, respectively. %C, %F, and %P were 40.9, 38.5, and 20.6, respectively. Especially the preoperative %P had markedly increased. Postoperatively, %C significantly decreased to 28.3, and %P showed a significant increase up to 30.3. Patients with ruptured intracranial aneurysms manifested a significant increase of %P and %F and a decrease of %C, postoperatively. In summary, the catabolism of fat and protein increases in the acute stage, especially postoperatively, and this hypermetabolic state should be considered when caring for patients with cerebrovascular diseases as malnutrition might prevent wound healing and cause weight loss and a decrease in immunity.

Acute Disease↗

PubMed1990

Clinical application of stable xenon CT-CBF studies without denitrogenation.

Noninvasive and simplified methods for estimating regional cerebral blood flow (CBF) and regional partition coefficient (lambda) using the inhalation of stable xenon (Xes) and computed tomographic (CT) scanning are described. Thirty percent Xes in 70% oxygen was inhaled for 240 seconds and exhaled for 160 seconds during serial CT scanning without denitrogenation in 26 patients with cerebrovascular diseases and four volunteer controls. During the investigation, the end-tidal Xes concentration was continuously monitored with a thermoconductivity analyzer to determine the build-up range (A value) and build-up rate constant (K value) of the artery by the curve fitting method. Calculated A and K values were corrected by the following formulae reported previously: for patients aged 0-20 years, Ae = 0.75Aa + 2.15, Ke = 0.67Ka + 0.69; 21-40 years, Ae = 0.56Aa + 3.24, Ke = 0.38Ka + 1.12; 41-60 years, Ae = 0.91Aa + 1.95, Ke = 0.38Ka + 1.32; over 61 years, Ae = 0.52Aa + 3.81, Ke = 0.31Ka + 1.55 (Ae and Ke were calculated with end-tidal Xes concentration, Aa and Ka were calculated by direct sampling of arterial blood). A CBF map (f map) and lambda map made with corrected A and K values demonstrated reliable distribution. The CBF was high in the gray matter, low in the white matter, and much lower in the infarcted area. lambda was high in the white matter, low in the gray matter, and much lower in the infarcted area. Eight patients were examined with and without denitrogenation. Both the f map and lambda map with denitrogenation were compatible with those without denitrogenation.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗

PubMed1990

Addition computed tomography with stable xenon--special reference to ischemic cerebrovascular diseases.

Stable xenon (Xes) is used as a contrast agent because it freely diffuses to cerebral tissues through the blood-brain barrier. In this study, 2 axial levels for Xes enhancement analysis were selected from a baseline series of computed tomographic (CT) scans and 6 serial CT scans were obtained every 20 seconds for each scan level during the 240 seconds inhalation period of 30% Xes in 10 volunteer controls and in 52 patients with ischemic cerebrovascular diseases (ICVD). The serial CT scans were added and averaged in each pixel. This was used to make a new CT picture (addition CT scan). The CT scans before the Xes inhalation, the scan at the end of the Xes inhalation, and the addition CT scan were compared to see whether gray matter and ischemic areas could be differentiated from white matter. The addition CT scans could differentiate the three structures very well in both the acute and chronic stages of ICVD. This technique is thought to be a very simple and useful method to detect the small infarcted areas and low perfusion areas that cannot be visualized on precontrast CT scans.

Administration, Inhalation↗

PubMed1990

Hemodynamic evaluation before and after the STA-MCA anastomosis--with special reference to measurement of regional transit time with intra-arterial digital subtraction angiography.

Twenty-seven patients with minor completed and major stroke in the chronic stage underwent superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. The regional cerebral blood flow (rCBF), using inhalation of stable xenon and computed tomographic scanning (Xes CT-CBF study), and the mode of transit time (MTT) in the MCA territory using intra-arterial digital aortography were measured. Activated rCBF and MTT was measured 20 minutes after the administration of acetazolamide (10 mg/kg) in 14 patients. Nineteen of the 23 patients with minor stroke (Group 1) showed immediate improvement in their neurological state within a few days of the operation, while four patients with minor stroke (Group 2) and four patients with major stroke (Group 3) showed no improvement. Based on the rCBF obtained with the Xes CT-CBF study, affected side rCBF/unaffected side rCBF and %f [(peak DSA number/affected side MTT)/(peak DSA number/unaffected side MTT)] were compared. There was a significant positive correlation. Affected side MTT in Group 1 was 6.41 +/- 1.16 sec, preoperatively, and significantly decreased to 5.13 +/- 0.91 sec after the operation. On the other hand, preoperative MTT in Group 2 was 4.40 +/- 0.81 sec and 4.76 +/- 0.89 sec, postoperatively. Preoperative %f in Group 1 was 0.514 +/- 0.143 and significantly increased to 0.739 +/- 0.154, postoperatively. Group 2 showed no change. Vasodilatory capacity with acetazolamide showed a marked improvement in Group 1, postoperatively. Our study indicated that if MTT is moderately lengthened, %f is moderately decreased, and vasodilatory capacity is impaired, in patients with minor ischemic stroke will benefit from STA-MCA anastomosis.

Angiography, Digital Subtraction↗

PubMed1990

Mechanism of the re-buildup phenomenon in moyamoya disease--analysis of local cerebral hemodynamics with intra-arterial digital subtraction angiography.

The authors investigated the mechanism of the re-buildup phenomenon on electroencephalogram in 14 patients of moyamoya disease with superficial temporal artery-middle cerebral artery anastomosis. Visualization of the lateral view of the common carotid angiography was performed with intra-arterial digital subtraction angiography (IA-DSA), using a 4/sec x 3 sec + 2/sec x 5 sec + 1/sec x 5 sec film sequence. The catheter tip was inserted into C5/6 level and 250 mgI/ml of iopamidol was used as the contrast agent; 6 ml in total was injected over 1.5 seconds. Circulation times of the common carotid artery (C3 portion)-ascending parietal vein (delta TTPs) and common carotid artery-internal cerebral vein (delta TTPD) were measured before hyperventilation (HV), immediately after HV, and 3 minutes after HV during pre- and postoperative periods. delta TTPD in the preoperative period was prolonged by HV and was normalized at 3 minutes after HV but delta TTPs were prolonged immediately after and 3 minutes after HV. In the postoperative period, however, these values did not change significantly immediately after and 3 minutes after HV. These findings indicate that delayed cerebral blood flow response to HV is a pathogenetic factor of the re-buildup phenomenon in moyamoya disease.

Adolescent↗

PubMed1990

Hypermetabolism in the acute stage of hemorrhagic cerebrovascular disease.

Oxygen consumption (VO2), carbon dioxide production (VCO2), urinary nitrogen excretion, respiratory quotient, resting energy expenditure (REE), %REE, and the consumption rates of carbohydrate, fat, and protein (%CHO, %Fat, %Prot, respectively) were determined pre- and postoperatively by indirect calorimetry in 13 patients with ruptured intracranial aneurysms and 11 patients with hypertensive intracerebral hemorrhage in the acute stage. The preoperative VCO2, VO2, urinary nitrogen excretion, respiratory quotient, REE, and %REE were, respectively (mean +/- standard deviation): 171 +/- 46 ml/min, 203 +/- 56 ml/min, 10.3 +/- 1.7 gm/day, 0.84 +/- 0.01, 1397 +/- 389 Cal/day, and 129% +/- 8%. The values for VCO2, VO2, REE, and %REE were all increased above normal levels. The %Prot was increased to 26.1% +/- 9.1%. In the postoperative period, the VCO2, VO2, urinary nitrogen excretion, REE, and %REE significantly increased to: 186 +/- 44 ml/min, 229 +/- 56 ml/min, 14.8 +/- 2.9 gm/day, 1557 +/- 384 Cal/day, and 141% +/- 21%, respectively. The %Fat and %Prot also increased significantly, but the %CHO significantly decreased. Preoperatively, in the patients with ruptured intracranial aneurysms, there was a greater increase in %Prot in eight patients classified (according to Fischer) as having a Group 3 or 4 subarachnoid hemorrhage (SAH) on computerized tomography than in five patients classified as having a Group 1 or 2 SAH. In summary, increased metabolic expenditure, especially increased catabolism of protein and fat, is characteristic of accompanying hemorrhagic cerebrovascular disease, and there is an increase in consumption of fat and protein in the postoperative period. Lack of precise knowledge about the cause and consequences of these metabolic responses makes it impossible at present to judge the optimal extent of nutritional replacement. The hypermetabolic state should be taken into consideration when caring for these patients as it may cause weight loss, poor wound healing, and susceptibility to infection.

Acute Disease↗

PubMed1990

[Amylase-producing extramedullary plasmacytoma with multiple cutaneous metastasis following a solitary plasmacytoma of bone].

A 65-year-old woman was admitted because of multiple cutaneous tumors in the left lumbar area in March 1983. In 1979, she had been diagnosed as solitary plasmacytoma (IgG, kappa) of the left femur and amputation of the left leg had been performed. In 1981, the tumor relapsed in the left ilium in association with an increased level of serum IgG with M-component and normal activity of serum amylase. The serum M-protein had been disappeared after resection of the tumor. On admission laboratory examinations showed a slightly high level of serum IgG and elevated activities of serum and urine amylase. Amylase isoenzyme analysis revealed a predominance of the S-isozyme. Bone marrow aspiration revealed no atypical plasma cells. The supernate of cultured plasma cells obtained from the cutaneous tumor contained high amylase activity consisting exclusively of S-type. Thereafter serum amylase activities changed approximately in parallel with serum M-protein levels and total tumor volumes after chemotherapy or radiotherapy. At the terminal phase in 1986, however, serum amylase activities became extraordinarily high compared with serum M-protein levels, suggesting a clonal change of the plasmacytoma cells.

Aged↗

PubMed1990

[Assessment of the antitumor effect after remission induction therapy for non-Hodgkin's lymphoma--an approach to a response-adapted therapy].

We assessed the response of various tumors, following each of three consecutive courses of CHOP or CHOP-Bleo therapy in 32 untreated patients with intermediate or high-grade non-Hodgkin's lymphoma (NHL), and also retrospectively compared these results to those for a group in whom complete remission (CR) had been obtained within five courses and a non-CR group. A low CR rate was observed in these patients who showed no or only temporary antitumor effects (persistent increase, no change, or increase after a transient decrease) after two courses of therapy. Furthermore, we measured total tumor volume and tumor regression rate after each course of therapy in 21 patients who had measurable tumors, and determined their cut off values for distinguishing between CR and non-CR. When the cut off values were applied to the effects observed in the 21 patients, positive predictive values after each course of therapy were high. False negative values after the second course of the therapy were low, and showed 0% when the cut off value determined from tumor regression rate was used. These results suggest that we can accurately predict the probability of CR after the second course of CHOP or CHOP-Bleo therapy, although this should be further confirmed by prospective study. In addition, such an analysis may prove useful in setting up individualized response-adapted therapy for NHL.

Adult↗

PubMed1990

[Tuberculosis sequelae: secondary bacterial infections].

Bacterial infections is one of the most important complications in the patients with pulmonary tuberculosis. We reported the causative microorganisms in these cases with special reference to various clinical features and presented the recommended treatment and prophylaxis against respiratory bacterial infections in the patients with pulmonary tuberculosis sequelae. In 1988 and 1989, 63 patients with tuberculosis sequela were demonstrated to have been infected with respiratory pathogenic bacteria by the quantitative sputum culture method (greater than or equal to 10(7)/ml) in Tokyo National Chest Hospital. The male/female ratio of these patients was 3.5, and their average age was 62.5 years. Causative microorganisms of the secondary infections in the patients with tuberculosis sequela were essentially similar in those with other lower respiratory tract infections, i.e., chronic bronchitis, bronchiectasis, diffuse panbonchiolitis, chronic pulmonary emphysema, etc. Pseudomonas aeruginosa, other glucose-nonfermentative Gram-negative bacilli (GNF-GNB), and glucose-fermentative Gram-negative bacilli (GF-GNB) were the major pathogenic bacteria responsible for the chronic respiratory failure and/or fatal outcome in the post-tuberculous patients. Patients with complications, including aspergillosis, atypical mycobacteriosis, bronchial asthma, and so forth, showed no specific causative microorganism for the secondary infections except frequent isolation of Haemophilus influenzae. Our clinical observations clearly demonstrated that there were differences between the causative microorganisms in patients hospitalized during 1988 to 1989 and those in patients without admission. Gram-negative bacilli, including P. aeruginosa, GNF-GNB and GF-GNB, and Staphylococcus aureus were predominant in hospitalized patients. On the contrary, Streptococcus pneumoniae, H. influenzae, and Branhamella catarrhalis were major pathogenic bacteria in patients without hospitalization.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

[Transbrachial artery approach for selective cerebral angiography].

Transaxillary or transbrachial approaches to the cerebral vessels have been reported, but selective angiography of all four vessels has not been possible through one route. In this report, a new technique for selective cerebral angiography with transbrachial approach is described. One hundred and twenty three patients with cerebral infarction, vertebrobasilar insufficiency, intracerebral hemorrhage, epilepsy, or cerebral tumor were examined. Those patients consisted of 85 outpatients and 38 inpatients whose age ranged from 15 years old to 82 years old. The patients were examined via the transbrachial approach (97 cases via the right brachial, 29 cases via the left). Materials included a DSA system (Digital Fluorikon 5000, General Electric Co.), a 4 French tight J-curved Simmons 80-cm catheter, a 19-gauge extra-thin-wall Seldinger needle, and a J/Straight floppy 125-cm guidewire. Generally, the volume of the contrast agent (300 mgI/ml iopamidol) used in the common carotid artery angiogram was 6 ml, while that used in the vertebral artery angiogram was 4ml. If catheterization of the vertebral artery or right common carotid artery was unsuccessful, about 8ml of the contrast agent was injected into the subclavian or brachiocephalic artery. Definitive diagnosis and a decision on proper treatment of the patients can be easily obtained, and the results were clinically satisfactory. Moreover, no complications were encountered in this study. This new technique making a transbrachial approach to the cerebral vessels using the DSA system is introduced here. Neurosurgeons can use this technique easily, and they will find that it provides them with all the information they need about the patient.

Adolescent↗

PubMed1989

T cells from eosinophilic patients produce interleukin-5 with interleukin-2 stimulation.

Anti-murine (m) interleukin-5 (IL-5) antibody was found to inhibit eosinophil (Eo) colony formation stimulated by recombinant human (rh) IL-5, but did not inhibit the production of Eo stimulated by rh IL-3 or granulocyte-macrophage colony-stimulating factor (GM-CSF). Conditioned medium (CM) prepared from eosinophilic patients' T cells with interleukin-2 (IL-2) stimulation (T-IL-2-CM), was found to contain CFU-Eo growth-stimulating factor. Using anti-mIL-5 antibody, we demonstrated that T-IL-2-CM from patients with eosinophilia contained a significant amount of IL-5. We also detected IL-5 mRNA in T cells from eosinophilic patients with IL-2 stimulation. These results suggest that IL-5 plays an important role in the induction of selective eosinophilia in humans and that IL-5 is produced from T cells with IL-2 stimulation.

Adult↗

PubMed1989

Neurogenic pulmonary edema in the acute stage of hemorrhagic cerebrovascular disease.

Extravascular lung water (EVLW) was measured by the double-indicator dilution method in 25 patients with hemorrhagic cerebrovascular diseases. EVLW had a significantly positive correlation with both alveolar-arterial oxygen difference (AaDO2) and intrapulmonary shunt. The value of EVLW in the acute stage in 15 patients with increased AaDO2 more than 20 mm Hg was 7.8 +/- 2.2 ml/kg and that in the chronic stage 4 weeks after onset significantly decreased to 4.6 +/- 0.7 ml/kg (P less than 0.001). The value of EVLW in the acute stage in 10 patients with normal AaDO2 less than 20 mm Hg was 4.7 +/- 1.1 ml/kg and that in the chronic stage 4 weeks after onset was 4.5 +/- 0.2 ml/kg. There was no significant difference between them. Pulmonary arterial blood pressure, pulmonary capillary wedge pressure, central venous pressure, cardiac index, systemic vascular resistance index, and pulmonary vascular resistance index in the acute stage in the 25 patients were all within the normal range. Three patients with neurogenic pulmonary edema had markedly increased EVLW without abnormalities in pulmonary arterial blood pressure, pulmonary capillary wedge pressure, central venous pressure, cardiac index, systemic vascular resistance index, and pulmonary vascular resistance index. From these facts, the main cause of the increase in EVLW cannot be explained by left ventricular failure, but can be explained by high permeability pulmonary edema.

Adult↗