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Biomedical subjects

J Tajiri

Publications and source records attributed to J Tajiri.

At least 37 records · Page 2Linked to original sources
PubMed1988

Follicular thyroid carcinoma with clear cell change showing unusual ultrastructural features.

We report a case of follicular thyroid carcinoma with clear cell change displaying unusual ultrastructural features. Light microscopy revealed a metastatic neoplasm in the 12th thoracic vertebra that was composed of nests consisting mainly of clear cells. The tumor was interpreted as a metastasis of a clear cell type of thyroid carcinoma, based on positive immunohistochemical staining for thyroglobulin. However, unlike the metastatic bone lesions, the primary tumor in the thyroid consisted mainly of neoplastic follicular cells with lightly eosinophilic cytoplasm. A distinct follicular formation was noted throughout the tumor. In a portion of the tumor, a solid or stratified disposition of the cells was also observed. The primary tumor contained only a few clear cells similar to those seen in the metastatic bone lesions. In addition, we noted a transition between the follicular cells and the clear cells. Thus, this neoplasm was diagnosed as a follicular thyroid carcinoma with clear cell change, but not a specific type of thyroid neoplasm. Electron-microscopic examination revealed that the cells corresponding to clear cells under light microscopy had abundant cytoplasm characterized by varying degrees of dilation of rough endoplasmic reticulum (RER), which might reflect increased synthesis, storage of secretory products, or both.

Adenocarcinoma↗
PubMed1987

Low serum reverse T3 levels in patients with primary hyperparathyroidism.

Although patients with primary hyperparathyroidism (1 degree HPT) were euthyroid, we measured serum thyroid hormone levels in 16 patients with 1 degree HPT together with 17 patients with hypercalcemia due to malignant diseases (HCM). In patients with 1 degree HPT, serum levels of T3, T4 and T3U were within normal range, but serum rT3 (reverse T3) levels (205 +/- 37 pg/ml, mean +/- SD) were significantly decreased as compared with those in normal controls (276 +/- 44 pg/ml, P less than 0.01). A significant inverse correlation was observed between the serum levels of rT3 and parathyroid hormone (PTH) (r = 0.54, P less than 0.05). After parathyroidectomy, serum rT3 levels were significantly elevated (240 +/- 56 pg/ml) compared to preoperative levels (P less than 0.01). Low levels of serum rT3 seemed to be attributed to the high levels of serum PTH. On the other hand, serum levels of T3 and T4 were low and serum rT3 levels were high in patients with HCM. Low serum rT3 allows for the differentiation of patients with 1 degree HPT from those with HCM.

Adolescent↗
PubMed1987

The effect of iopanoic acid on thyrotropin secretion in patients with cirrhosis of the liver.

Ten patients with liver cirrhosis and six normal subjects were studied to evaluate the effect of iopanoic acid (IA) on thyrotropin secretion. A thyrotropin-releasing-hormone (TRH) test was performed before and 5 days after IA administration (single oral dose of 3 g). After IA administration, a significant increase in TSH response to TRH was observed in normal subjects. In cirrhotics, however, it did not significantly increase after IA administration. The serum T3 and T3/TBG ratio were significantly decreased and the serum T4 and T4/TBG ratio were increased after IA administration in normal subjects and cirrhotics. There was no significant difference in the % decrease in serum T3, % increase in serum T4 or other thyroid hormone parameters including TSH in IA induced TSH responders (R) and non-responders (NR). However, r-T3 before and after IA in R was higher than those in NR. The values for hepatic function tests such as serum albumin, prothrombin time, 45 minutes retention rate of bromsulphalein (BSP 45 min) and the cholinesterase (ChE) level in R were not different from those of NR. These results suggested that in cirrhotics, abnormal regulation of the hypothalamo-pituitary system might exist.

Adult↗
PubMed1986

Studies of hypothyroidism in patients with high iodine intake.

Twenty-two patients with spontaneously occurring primary hypothyroidism were studied to evaluate the spontaneous reversibility of the hypothyroid state. Twelve (54.5%) became euthyroid after restriction of iodine intake for 3 weeks (reversible type). In the remaining 10 patients, thyroid function did not improve with restriction of iodine alone, and thus, replacement therapy was required, (irreversible type). In the reversible type, 1) radioactive iodine uptake after 1 week of restricted iodine intake was higher than in the irreversible type [50.0 +/- 12.2% (+/- SD) vs. 4.3 +/- 3.2%; P less than 0.01], 2) the perchlorate discharge test was positive in 2 of 10 patients, and 3) the iodine-perchlorate discharge test, carried out in 7 of 8 patients with negative perchlorate discharge test, was positive in 6. Seven patients with the reversible type were given 25 mg iodine daily for 2-4 weeks; all became hypothyroid again. Two patients had a history of habitual ingestion of seaweed (25.4 and 43.1 mg iodine, respectively), but the remaining 10 patients ingested ordinary amounts of iodine (1-5 mg) daily. The patients with reversible hypothyroidism had focal lymphocytic thyroiditis changes in the thyroid biopsy specimen, whereas those with irreversible hypothyroidism had more severe destruction of the thyroid gland. These results indicate the existence of a reversible type of hypothyroidism sensitive to iodine restriction and characterized by relatively minor changes in lymphocytic thyroiditis histologically. Attention should be directed to this type of hypothyroidism, because thyroid function may revert to normal with iodine restriction alone.

Adult↗
PubMed1986

Masked thyroid dysfunction among elderly patients with atrial fibrillation.

Seventy-five elderly patients with atrial fibrillation (41 males and 34 females with a mean age of 75.6 years) were studied to evaluate the incidence of masked thyroid dysfunction. A thyrotropin (TSH)-releasing-hormone (TRH) test (intravenous injection of 250 micrograms of synthetic TRH) was performed in the patients and 30 age matched controls without atrial fibrillation. In the controls, no abnormal TRH stimulated TSH response was observed. In the patients with atrial fibrillation, no response of TSH to TRH (hyperthyroidism) was found in 5 cases (6.6%), while hyperresponse of TSH to TRH (hypothyroidism) was found in 6 cases (8.0%). Thyroid dysfunction (hyper or hypothyroidism) was more frequently observed in the patients than in the controls (p less than 0.05). Two of 5 hyperthyroid patients had normal thyroid hormone levels. All patients with hyperthyroidism were treated with antithyroid drugs or 131I. Unfortunately, atrial fibrillation persisted in all but 1 case. It is concluded that the TRH test is a useful screening test for detecting those patients with abnormal thyroid function among elderly patients with atrial fibrillation, and that hypothyroidism should be considered as a cause of atrial fibrillation in the elderly.

Aged↗
PubMed1986

Elevation of anti-DNA antibody titer during thyrotoxic phase of silent thyroiditis.

The elevation of anti-DNA antibody titers was observed in two cases of silent thyroiditis; the levels reverted to normal as thyrotoxicosis improved. Biopsy specimens of the thyroid gland revealed chronic lymphocytic thyroiditis. The elevation of anti-DNA antibody titers during the thyrotoxic phase of silent thyroiditis, to our knowledge, has not been reported. In one case, antinuclear antibody testing was also positive during the thyrotoxic phase and became negative in the euthyroid state. These observations provide further support for autoimmunity in silent thyroiditis.

Antibodies, Antinuclear↗
PubMed1985

Clinical usefulness of the (chloride-90)/phosphate ratio for distinguishing primary hyperparathyroidism from hypercalcemia due to other causes.

In order to obtain a good separation line between patients with primary hyperparathyroidism (1 degree HPT) and those with non-parathyroidal hypercalcemia (NPHC), serum chloride (Cl) and phosphate (P) concentrations were analyzed. Ninety-nine per cent of the patients with 1 degree HPT had a Cl/P ratio greater than or equal to 33, but 29% of patients with NPHC were also included in this range. When the (Cl-90)/P ratio was used to separate into two groups, 98% of the patients with 1 degree HPT had a ratio greater than or equal to 5.0, and 94% of the patients with NPHC had a ratio less than 5.0. From these results, while high sensitivity was achieved both with the Cl/P and (Cl-90)/P ratios, the (Cl-90)/P ratio provided higher specificity. Therefore we conclude that the (Cl-90)/P ratio was excellent in distinguishing 1 degree HPT from other types of hypercalcemia.

Adult↗
PubMed1985

The cause of low voltage QRS complex in primary hypothyroidism. Pericardial effusion or thyroid hormone deficiency?

In order to clarify the cause of low voltage QRS complex seen on ECG (low voltage), thyroid hormones, LDH isozyme and pericardial effusion (PE) were studied in 39 patients with primary hypothyroidism. Low voltage and PE were found in 12 of 39 (30.8%) and 12 of 27 (44.4%), respectively. Serum T4 in patients with low voltage (Group 1) was significantly lower than that in patients without low voltage (Group 2) (T4 1.4 +/- 1.7 vs 2.8 +/- 2.3 micrograms/dl, p less than 0.05). Group 1 had a higher incidence of large amounts of PE than Group 2 (6/8 vs 1/19, p less than 0.002). However, there was no significant difference in thyroid hormone levels between patients with and without PE. No significant difference in LDH isozyme pattern was found among the groups. Low voltage without PE was found in only one patient. Two patients with low voltage and PE demonstrated that in spite of the presence of large PE, low voltage improved after thyroid replacement therapy. By multi-variate analysis, low voltage was related to large PE, patient age and low T4 levels. From these results, it was suggested that in hypothyroidism low voltage was brought about by a combination of both severe thyroid hormone deficiency and large PE. In addition, elderly patients over 60 years had low voltage more frequently than did patients under 59 years.

Adult↗
PubMed1984

Successful treatment of thyrotoxic crisis with plasma exchange.

A 36-yr-old woman with thyroid storm was successfully treated with plasma exchange. After the first plasma exchange, free serum thyroxine (T4) was decreased and serum thyroxine-binding globulin (TBG) was significantly increased. The decrease in the patient's free T4 level after plasma exchange can perhaps be attributed to T4's increased binding capacity. Plasma exchange may be an effective therapy for thyrotoxic crisis and should be performed immediately if conventional therapy fails to improve the patient's condition.

Adult↗
PubMed1984

The effects of the respiratory cycle by mechanical ventilation on cardiac output measured using the thermodilution method.

The feasibility of the thermodilution technique to measure cardiac output (CO) during positive pressure ventilation was assessed in 12 critically ill patients. An indicator (5 ml of 5% glucose in cold water) was injected at the mid and end of the inspiratory and expiratory phases of mechanical ventilation to see the effects of the respiratory cycle on thermodilution data. The 36 measurements at mid-inspiration yielded the smallest coefficient of variation (CV), 2.7%. The CV of 36 randomly selected measurements was 6.0%. CO at end-inspiration gave the highest value (p less than 0.05). These data suggested that one major disadvantage of the thermodilution method, the need for repeated measurement to minimize the variation in data, could be overcome by timing the injection according a certain phase of mechanical ventilation.

Adolescent↗
PubMed1984

Interrelation between plasma amino acid composition and growth hormone secretion in patients with liver cirrhosis.

We examined the possibility that abnormalities of growth hormone (GH) release in cirrhotic patients were related to a reduction in the ratio of branched chain amino acids (BCAAs) to aromatic amino acids (AAAs) in plasma. The intravenous infusion of 250 micrograms of thyrotropin-releasing hormone (TRH) caused a significant rise in plasma GH greater than 5 ng/ml and more than twice as much as the basal levels in 7 out of 15 patients (responders) but an insignificant rise in the remaining patients (non-responders). The difference in the basal GH level was not significant. The oral glucose load suppressed plasma GH in all of the normal subjects and 6 of 7 non-responders, while it was elevated in 6 of 7 responders and one of the non-responders. The ratio of BCAAs to AAAs in the plasma of cirrhotic patients was 1.21 +/- 0.38, which was significantly lower than that of normal subjects (3.31 +/- 0.42, p less than 0.01). In addition, there was a significant difference between responders and non-responders in the ratios (0.96 +/- 0.22 vs 1.42 +/- 0.36, p less than 0.05). An inversely significant correlation (p less than 0.05) between the ratios of BCAAs to AAAs in plasma and the peak levels of GH after TRH injection was observed when all subjects were combined, but no correlation was found between the ratios and the peak levels of GH after oral glucose loading. There were also significant correlations (p less than 0.01) between the ratios and various parameters including the serum albumin, cholinesterase and indocyanine green disappearance rate constant (KICG).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗