Biomedical subjects

J Shimizu

Publications and source records attributed to J Shimizu.

At least 163 records · Page 9Linked to original sources

PubMed1994

Hemolytic uremic syndrome without hemolytic anemia: a case report.

Hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. Most cases of HUS are caused by E. coli O157:H7 verotoxin. In the case reported here, diarrhea continued for twenty days after an E. coli 0157:H7 infection and was followed by acute renal failure and thrombocytopenia. Examination of percutaneous renal biopsy tissue showed typical HUS findings, e.g., mesangiolysis in glomeruli and thickening of capillary walls with prominent double outlines, but there was no indication of hemolytic anemia. LDH and haptoglobin, indications of hemolytic anemia, were in the normal range throughout the patient's clinical course. The patient's red blood cells had P1 antigen, which reportedly provides protection by adsorption of toxin into the red blood cells thereby preventing or limiting toxic damage to other organs. Therefore, we assumed that because of the expression of P1 antigen in this patient, the kidneys were not severely damaged and microangiopathic hemolytic anemia was thereby avoided.

Acute Kidney Injury↗

PubMed1994

[A case report of light and heavy chain deposition disease (IgG2 lambda)].

A 73-year-old male was admitted to the renal division of our hospital because of hypertension, proteinuria and bilateral pretibial edema. Eight years previously, he was diagnosed as being afflicted with interstitial pneumonia on the basis of a chest X-ray examination. Laboratory tests conducted during the current admission showed normocytic normochromic anemia, renal dysfunction and mild proteinuria. Total IgG was normal, but a high proportion of IgG2 was observed. M-protein in the serum was positive for both IgG lambda and Bence Jones protein (lambda type). A bone marrow biopsy showed the proportion of plasma cells to be 10.6%, but atypical cells were not found. We diagnosed the patient's condition as plasma cell dyscrasia. Light microscopy examination of a renal biopsy specimen showed moderate mesangial proliferation with a deposition of PAS-positive and Congo red negative materials in the mesangial area: nodular gomerulonephritis was seen in some glomeruli. Immunofluorescence revealed IgG and lambda light chains, strong linear staining along the glomerular basement membrane and tubular basement membrane and positivity in the mesangial area. Results of staining for IgA, IgM, fibrinogen and C3 were weakly positive in the mesangium area, while those for C4, Clq and free kappa were negative. Positive staining of IgG2 was seen by immunoperoxidase study, but the tissue was negative for IgG1, IgG3, IgG4. Electron microscopy demonstrated a dense granular deposition in the mesangial, subendothelial and peritubular area and a microfibrillar structure in the mesangial area. The diameter of the microfibrillar structure was 14 nm on the average.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1994

Cell-mediated immune response in acute poststreptococcal glomerulonephritis.

To evaluate the role of cell-mediated immunity in acute poststreptococcal glomerulonephritis (APSGN), we identified the immune cell population infiltrating the glomeruli. Renal biopsies were obtained from 22 patients with APSGN, 16 with overt and 6 with asymptomatic disease, one to 30 days after onset. Samples of normal renal tissue were used as controls. Frozen sections were examined using monoclonal antibodies that recognize various leukocyte surface markers. Double staining for granulocytes and monocyte/macrophages (M phi) was performed using chloro-esterase staining and indirect immuno-alkaline-phosphatase staining with Leu M-5 sequentially. In overt APSGN, there was a substantial increase in the total number of granulocytes and M phi with a slight increase in T cells. Numbers correlated with time after onset, as more leukocytic infiltration was observed when the tissue was taken earlier. Furthermore, a significant positive linear correlation was seen between helper/inducer T cells and M phi (r = 0.86, p < 0.01). Helper T cells tended to be increased to a higher proportion during the early stage, while suppressor T cells remained constant throughout the course. Analysis with anti-proliferating cell nuclear antigen antibody revealed increased glomerular cell proliferation in the early phase of APSGN. In asymptomatic patients, the total number of leukocytes was less than in the overt patients, but the proportions of infiltrating cells were similar. These data suggest that M phi are important effector cells causing endothelial and mesangial cell proliferation in APSGN. M phi infiltration in the glomeruli appears to be mediated by complement-induced chemotaxis and probably be an antigen-specific event related to the delayed type hypersensitivity mediated by helper/inducer T cells.

Acute Disease↗

PubMed1994

[A case of infantile thoracic actinomycosis involving the bronchocutaneus fistula].

Pulmonary actinomycosis is rare at present. A 11-year-old girl complained of left anterior chest pain and chest wall swelling. A radiograph of the chest revealed a consolidation in the left upper lobe. Sputum cultures showed normal flora and sputum cytology was negative for malignant disease. On 16 days after admission, the infection involved the bronchocutaneous fistula. Surgery was necessary to curettage. Histopathological specimen of resected necrotic tissue showed typical "sulfur granule" of actinomycosis. We administered penicillin for 3 months and the consolidation disappeared.

Actinomycosis↗

PubMed1994

[A case of pulmonary cryptococcosis diagnosed by percutaneous lung biopsy].

A 53-year-old male was admitted with complaint of bloody sputum. The chest X-ray film revealed a solitary round mass with cavity formation in the left upper lung field. A diagnosis of pulmonary cryptococcosis was made by the percutaneous lung biopsy. As his chest X-ray film did not improve even by administration of antimycotic agents for 6 months, he underwent partial resection of left upper lobe. Thus, the percutaneous lung biopsy was a significant procedure for the definitive diagnosis of this case.

Biopsy, Needle↗

PubMed1994

[A female case of adenocarcinoma of the lung producing human chorionic gonadotropin].

A 72-year-old female was admitted with complaints of cough and sputum. The chest X-ray film revealed a solitary round mass and pleural effusion in the left lower lung field. Laboratory tests demonstrated elevated levels of serum HCG and beta-HCG. Left lower lobectomy with parietal pleurectomy was performed under the diagnosis of primary lung cancer with malignant effusion. The serum HCG level decreased after the operation. Histologically, the tumor was diagnosed as moderately differentiated papillo-tubular adenocarcinoma of the lung. In the HCG staining using an immunohistochemical method, the tumor cells showed a positive reaction. Thus, this tumor was definitively diagnosed to be HCG-producing adenocarcinoma of the lung.

Adenocarcinoma↗

PubMed1994

[Clinical significance of extended mediastinal lymph node dissection on the basis of clinicopathological analysis of nodal involvement in bronchogenic carcinoma].

During the past 20 years, 1,064 cases of non-small cell lung cancer underwent resectional surgery in which all accessible mediastinal lymph nodes were dissected. Among 288 patients with histologically proven N2 disease, 182 underwent complete dissection of the mediastinal lymph nodes; 77 had one-level and 105 had multi-level metastases. Fifteen percent of the patients having primary lesions with a maximal diameter between 21 and 30 mm had N2 disease. Nodal metastases to the lower mediastinum from upper lobe cancer (nonregional metastasis) were frequently observed as were metastases of lower lobe cancer to the upper mediastinum. In addition, there were often skip metastases to the nonregional parts of the mediastinum without regional nodal involvement in the mediastinum. Among left-lung cancer patients, the group that underwent nodal dissection after mobilization of the aorta by dividing the Botallo's ligament frequently had a verified metastatic node at the tracheo-bronchial angle (#4) which might not have been detected without that procedure. In addition, many N2 and N3 diseases were detected by additional dissection through a median sternotomy. From the results of the present study, it appears that extensive mediastinal dissection should be recommended in surgery for lung cancer irrespective of the location and the size of the primary tumor.

Carcinoma, Bronchogenic↗

PubMed1994

[A case of early hilar lung cancer combined with intralobar pulmonary sequestration, both of which were treated by limited lung resection].

A 59-year-old man complained of fever due to infection in the intralobar pulmonary sequestration. On bronchoscopic examination, squamous cell carcinoma was found out at orifice of the left upper division bronchus. His pre-operative pulmonary function test showed low pulmonary reserve because of myelopathy. He underwent left S1 + 2 + S3 sleeve segmentectomy and S9 + 10 segmentectomy for intralobar pulmonary sequestration. He is well without any evidence of recurrence 10 months after surgery.

Bronchopulmonary Sequestration↗

PubMed1994

[Combined resection and replacement of the superior vena cava with an expanded polytetrafluoroethylene graft in surgery of pulmonary-mediastinal malignant tumor].

Combined resection and replacement of the superior vena cava with an expanded polytetrafluoroethylene graft was performed in 7 patients. Five patients had lung cancer, and 2 had malignant thymoma. During operation, total clamping of the superior vena cava was required in 2 patients, and partial clamping of the superior vena cava or clamping of the innominate vein in 5. The reconstruction procedures were as follows; the superior vena cava or bilateral innominate veins with a graft in 4 patients, bilateral innominate veins with 2 grafts in 1, and one of the innominate veins with a graft in 2. There was no operative death. Edema of face, neck and arms appeared in 6 patients postoperatively, but it disappeared in 3-10 days. Phlebogram which was obtained in 5 patients demonstrated patency of the grafts in 4 and well-developed collateral drainage in 1. Postoperative survival time was 1-27 months, and 3 patients are alive. No superior vena cava syndrome was recognized in long term observation of any patient.

Aged↗

PubMed1993

Nitric oxide production in islets from nonobese diabetic mice: aminoguanidine-sensitive and -resistant stages in the immunological diabetic process.

The role of nitric oxide (NO.) in the development of immunologically induced diabetes was examined. Transfer of spleen cells obtained from diabetic female nonobese diabetic (NOD) mice to nondiabetic irradiated males induced diabetes 11-13 days after transfer. Islets isolated from recipient male mice produced NO. in a time-dependent fashion. The production of nitrite was initially detected at day 6 after transfer, with increasing levels by days 9 and 13. Under similar conditions glucose-induced insulin secretion by isolated NOD mouse islets was irreversibly reduced by approximately 40% at days 6, 9, and 13 after transfer of spleen cells. The number of islets harvested per pancreas by the 9th and 13th day after transfer was decreased by 20-25% as compared to controls. Treatment of male NOD mice with aminoguanidine, an inhibitor of the inducible form of NO. synthase, reduced the production of NO. in islets and delayed the development of diabetes by 3-8 days. The temporary inhibition by aminoguanidine was dependent on both inhibitor concentration and number of spleen cells transferred. These results indicate that NO. is produced in NOD islets as a result of an immunological diabetogenic process and suggests a role of this compound in the immunological diabetic process.

Amino Acid Oxidoreductases↗

PubMed1993

Presentation of beta-cell antigens to CD4+ and CD8+ T cells of non-obese diabetic mice.

We isolated CD4+ and CD8+ T cell clones from pancreatic islets of non-obese diabetic (NOD) mice and studied their interactions with pancreatic islets, in culture. The three CD4+ T cell clones proliferated when cultured with islet cells from NOD, BALB/c, or C57BL/6 (B6) mice. For proliferation to the allogeneic islets, however, APC from NOD mice were required in the culture. Two of the clones also produced IFN-gamma upon culture with NOD islet cells. The Ag from islet cells responsible for T cell stimulation were not released into the supernatant but were cell associated. Paraformaldehyde treatment of islet cells, in fact, preserved their antigenicity. The fixed islet cells could present Ag to CD4+ T cell clones, provided live, syngeneic APC were added to the culture. We conclude from these experiments that islet cells donate Ag to the APC for presentation and that the function of APC is to process the Ag. The two CD8+ T cell clones proliferated and released IFN-gamma upon reaction with islet cells from either NOD or BALB/c but not B6 mice. The CD8+ T cell clones also reacted with the insulinoma NIT-1 cell line, derived from NOD mice. Fixation of NIT-1 cells did not impair recognition when live APC were present in the culture. In this case, however, the APC could be allogeneic. We conclude that CD8+ T cells directly recognized a MHC class I-restricted Ag on target cells, but needed the costimulatory effect of APC. We also found that CD8+ T cells killed islet cells. Two of the CD4+ T cell clones produced diabetes when transferred into male, irradiated NOD mice. For optimal transfer of disease, the CD4+ T cell clones had to be co-injected with CD8+ T cells from NOD diabetic mice. The two CD8+ T cell clones did not transfer disease.

Animals↗

PubMed1993

Demonstration of nucleolar organizer regions in lung carcinoma by silver staining.

Nucleolar organizer regions (NORs) were investigated in lung carcinomas by silver staining. This method was applied to 111 lung carcinoma specimens, including 40 with squamous cell carcinoma (SCC), 42 with adenocarcinoma (ADENO), 8 with adenosquamous carcinoma (ADESQ), 8 with small cell carcinoma (SMCC), 6 with large cell carcinoma (LGCC), and 7 with typical carcinoid tumors (CAOID). The mean AgNOR counts of ADENO, SCC, ADESQ, SMCC, and LGCC were significantly higher than those of the normal bronchial surface and those of the glandular or alveolar epithelium. The mean AgNOR count of CAOID was significantly higher than those of the normal glandular and alveolar epithelium but not that of the surface epithelium. The mean AgNOR count of SCC was significantly higher than that of bronchial squamous metaplasia, and the count of SMCC was significantly higher than that of CAOID. Within the same cancer category, the mean number of AgNORs increased in parallel with the histological tumor grades. These results indicate that the AgNOR method is useful for differentiating lung carcinoma from its normal counterparts and for evaluating histological tumor grades in the same lineage of lung carcinoma.

Adenocarcinoma↗

PubMed1993

Evaluation of surgical treatment of pyothorax with special reference to the usefulness of the omental pedicle flap method.

The operative results in a series of 17 patients with pyothorax were reviewed. Of these, 10 had chronic empyema (group 1), and 7 had postoperative empyema (group 2). A single-stage operation was performed in eight patients in group 1 (decortication in six, thoracoplasty in one, omental plombage in one) and in all patients in group 2 (omentopexy in five, thoracoplasty in two). Two-stage procedures were performed in two patients in group 1. We obtained favorable postoperative results in eight patients in group 1, and in four patients in group 2. In our series, good results were not obtained by thoracoplasty alone; however, satisfactory results were achieved by short-term management in patients treated with the omental method. We think this series demonstrates the value of the omental pedicle flap method, which prevents loss of function due to a defective organ and offers excellent therapeutic results following an easy operative procedure. Further active application of this method can be expected in the management of thoracic disorders.

Adult↗

PubMed1993

Tracheal reconstruction after lower tracheal resection using the inverted right bronchus--an experimental study.

An experimental study of tracheal reconstruction after lower tracheal resection using the inverted bronchus was performed in 8 dogs. After right upper lobectomy, the five cartilage rings of the lower trachea, ending three cartilage rings above the carina, was circumferentially resected; the right bronchus was transected just above the right second carina, the portion of the transected trachea above the carina was closed, and the right bronchus was inverted. The peripheral end of the upper trachea was anastomosed to the inverted right bronchus, and the intermediate bronchus was anastomosed to the lateral wall of the left bronchus. After completion of the airway reconstruction, the anastomotic site was wrapped with an omental flap. Although anastomotic complication were observed in two dogs, all the dogs survived the operation. Bronchoscopically and histopathologically, the findings for the inverted bronchus were almost normal three to four weeks after the operation. The clinical relevance of such a tracheal reconstruction is discussed.

Anastomosis, Surgical↗

PubMed1993

Abscessing bronchioloectasia with elements of plasma cell granuloma.

A 79-year-old male was admitted to the hospital with the complaint of bloody sputum. Chest X-ray revealed an abnormal shadow in the right upper lobe. Macroscopically, the lesion measured about 3.5 x 2.5 x 2.0 cm with a central cavity containing pus. Histologically, the lesion was composed of interlacing fibroblastic proliferation with abundant plasma cell infiltration and central cavitation. The inner surface of the cavity wall was partially covered by bronchial epithelial cells; there was no cartilage found, suggesting that the lesion had developed from chronic inflammatory processes in relation to ectatic bronchioles. Since the pathogenesis of plasma cell granuloma (PCG) has not been well established, it is probable that this case represents one stage in the development of classic PCG.

Aged↗

PubMed1993

Clinicopathological study of the effectiveness of tonsillectomy in IgA nephropathy accompanied by chronic tonsillitis.

Tonsillectomy is often effective in reducing proteinuria in patients with IgA nephropathy (IgAN), which might otherwise lead to renal failure. Twenty-eight patients with IgAN accompanied by chronic tonsillitis were observed for more than 2 years after tonsillectomy and studied clinicopathologically. Tonsillectomy was effective in 17 patients (effective group), but not effective in 11 (noneffective group). Many patients in the effective group showed mild proteinuria, whereas proteinuria of 1 g/24 h or higher was found in a few cases. In comparison with the noneffective group, the levels of serum IgA, polymeric IgA and circulating immune complex (CIC) in the effective group were significantly higher prior to tonsillectomy. Histopathologically, there was only a slight increase in mesangial cells and matrixes in the effective group compared with the noneffective group, and global glomerular sclerosis, small glomerular crescents and interstitial scarring were seldom found. Rupture of the glomerular basement membrane (GBM) occurred more frequently in the noneffective than in the effective group. In a study of IgA subclasses in the mesangial area of the glomerulus, IgA1 was predominantly stained in the effective group.

Chronic Disease↗

PubMed1993

Primary pulmonary hemangiopericytoma: a case report.

Primary pulmonary hemangiopericytoma is a very rare tumor. A case of the disease is reported, together with a review of the literature. The patient was a 78-year-old male, who was admitted to hospital with an abnormal shadow on his chest x-ray. A primary tumor, located in the left S4, was resected, and a final diagnosis of hemangiopericytoma of pulmonary origin was made. The disease recurred in the left lower lobe 14 months postoperatively. The patient received radiotherapy and is alive to date, 23 months after the operation.

Aged↗

PubMed1993

[Combined resection of the aortic wall in T4 lung cancer under the assistant devices].

Radical operation for T4 lung cancer is technically difficult. We report here 3 cases of T4N0M0 lung cancer involving aorta or left subclavian artery which was successfully operated on. We could carry out combined aortic resection more safely and speedy under the assistant devices, such as Anthrontube and Biomedicus Centrifugal Pump. Even T4 lung cancer having aortic invasion with N0 disease can be operated on and be expected long-term survival using these assistant devices.

Adenocarcinoma↗